Department of Psychology, University of Windsor, Windsor, ON, Canada.
Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Arch Clin Neuropsychol. 2023 Jan 21;38(1):139-153. doi: 10.1093/arclin/acac072.
Anti-leucine-rich glioma-inactivated 1 limbic encephalitis (LGI1-LE) is a rare autoimmune condition that affects the structural integrity and functioning of the brain's limbic system. Little is known about its impact on long-term neuropsychological functioning and the structural integrity of the medial temporal lobe. Here we examined the long-term neuropsychological and neuroanatomical outcomes of a 68-year-old male who acquired LGI1-LE.
Our case patient underwent standardized neuropsychological testing at two time points. Volumetric analyses of T1-weighted images were undertaken at four separate time points and qualitatively compared with a group of age-matched healthy controls.
At the time of initial assessment, our case study exhibited focal impairments in verbal and visual episodic memory and these impairments continued to persist after undergoing a course of immunotherapy. Furthermore, in reference to an age-matched healthy control group, over the course of 11 months, volumetric brain imaging analyses revealed that areas of the medial temporal lobe including specific hippocampal subfields (e.g., CA1 and dentate gyrus) underwent a subacute period of volumetric enlargement followed by a chronic period of volumetric reduction in the same regions.
In patients with persisting neurocognitive deficits, LGI1-LE may produce chronic volume loss in specific areas of the medial temporal lobe; however, this appears to follow a subacute period of volume enlargement possibly driven by neuro-inflammatory processes.
抗亮氨酸丰富的胶质瘤失活 1 型边缘脑炎（LGI1-LE）是一种罕见的自身免疫性疾病，影响大脑边缘系统的结构完整性和功能。关于其对长期神经心理学功能和内侧颞叶结构完整性的影响知之甚少。在这里，我们研究了一名 68 岁男性获得 LGI1-LE 的长期神经心理学和神经解剖学结果。
我们的病例患者在两个时间点接受了标准化的神经心理学测试。在四个不同的时间点进行了 T1 加权图像的容积分析，并与一组年龄匹配的健康对照组进行了定性比较。
在初始评估时，我们的病例研究表现出言语和视觉情景记忆的局部损伤，这些损伤在接受免疫治疗后仍持续存在。此外，与年龄匹配的健康对照组相比，在 11 个月的时间里，容积脑成像分析显示，内侧颞叶的区域，包括特定的海马亚区（例如 CA1 和齿状回）经历了亚急性的容积增大期，随后是同一区域的慢性容积减小期。
在持续存在神经认知缺陷的患者中，LGI1-LE 可能导致内侧颞叶特定区域的慢性体积损失；然而，这似乎是在神经炎症过程驱动的亚急性体积增大期之后发生的。
