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抗 N-甲基-D-天冬氨酸受体脑炎患者口面运动障碍与临床因素的相关性。

Association between clinical factors and orofacial dyskinesias in anti-N-methyl-D-aspartate receptor encephalitis.

机构信息

Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.

Department of Radiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

出版信息

Brain Behav. 2022 Jul;12(7):e2638. doi: 10.1002/brb3.2638. Epub 2022 May 27.

Abstract

BACKGROUND AND PURPOSE

We aimed to determine whether demographic information, clinical characteristics, laboratory tests, and imaging features are associated with orofacial dyskinesias (OFLD) in patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.

METHODS

In this retrospective study, patients who were diagnosed with anti-NMDAR encephalitis were enrolled. All patients' factors, including demographic information, clinical characteristics, laboratory tests, and imaging features, were obtained at the time of hospitalization. The neurological function was assessed using the modified Rankin scale (mRS). Univariate and multivariate logistic regressions were used to examine the associations between clinical factors and OFLD.

RESULTS

In total, 119 patients (median age: 28.0 [19.0-41.0] years; 67 females) were recruited. Of 119 patients, 44 (37.0%) had OFLD. OFLD was associated with increased mRS at admission, serum sodium, lumbar puncture pressure, female biologic sex, fever, psychiatric symptoms, seizures, impaired consciousness, autonomic dysfunction, and central hypoventilation in univariate logistic regression, respectively. Multivariate regression analysis revealed that female biologic sex (odds ratios [OR], 4.73; 95% confidence interval [CI], 1.27-17.64; p = .021), increased mRS at admission (OR, 2.09; 95% CI, 1.18-3.71; p = .011), psychiatric symptoms (OR, 7.27; 95% CI, 1.20-43.91; p = .031), and seizures (OR, 5.11; 95% CI, 1.22-21.43; p = .026) were associated with OFLD, after adjusting for confounding factors.

CONCLUSIONS

Our analysis suggests that the following clinical factors are associated with OFLD: female biologic sex, increased mRS at admission, psychiatric symptoms, and seizures.

摘要

背景与目的

我们旨在确定抗 N-甲基-D-天冬氨酸受体(NMDAR)脑炎患者的人口统计学信息、临床特征、实验室检查和影像学特征是否与口面运动障碍(OFLD)相关。

方法

在这项回顾性研究中,我们纳入了被诊断为抗 NMDAR 脑炎的患者。所有患者的人口统计学信息、临床特征、实验室检查和影像学特征均在住院时获得。使用改良 Rankin 量表(mRS)评估神经功能。使用单变量和多变量逻辑回归来检查临床因素与 OFLD 之间的关联。

结果

共纳入 119 例患者(中位年龄:28.0[19.0-41.0]岁;67 例女性)。119 例患者中有 44 例(37.0%)存在 OFLD。单变量逻辑回归显示,入院时 mRS 评分升高、血清钠、腰椎穿刺压、女性生物学性别、发热、精神症状、癫痫发作、意识障碍、自主神经功能障碍和中枢性通气不足与 OFLD 相关。多变量回归分析显示,女性生物学性别(比值比 [OR],4.73;95%置信区间 [CI],1.27-17.64;p=0.021)、入院时 mRS 评分升高(OR,2.09;95% CI,1.18-3.71;p=0.011)、精神症状(OR,7.27;95% CI,1.20-43.91;p=0.031)和癫痫发作(OR,5.11;95% CI,1.22-21.43;p=0.026)与 OFLD 相关,在调整混杂因素后。

结论

我们的分析表明,以下临床因素与 OFLD 相关:女性生物学性别、入院时 mRS 评分升高、精神症状和癫痫发作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02dd/9304820/96a8586a0a47/BRB3-12-e2638-g002.jpg

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