Zhang Xin, Liang Feiqiang, Lu Haolin, Chen Chuyi, Long Sina, Li Zuoxiao, Ruan Jianghai, Zhang Dechou
Department of Neurology, The Affiliated Hospital of Southwest Medical University, 646000 Luzhou, Sichuan, China.
Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, 646000 Luzhou, Sichuan, China.
J Integr Neurosci. 2024 May 11;23(5):99. doi: 10.31083/j.jin2305099.
The alterations of the functional network (FN) in anti-N-methyl-Daspartate receptor (NMDAR) encephalitis have been recognized by functional magnetic resonance imaging studies. However, few studies using the electroencephalogram (EEG) have been performed to explore the possible FN changes in anti-NMDAR encephalitis. In this study, the aim was to explore any FN changes in patients with anti-NMDAR encephalitis.
Twenty-nine anti-NMDAR encephalitis patients and 29 age- and gender-matched healthy controls (HC) were assessed using 19-channel EEG examination. For each participant, five 10-second epochs of resting state EEG with eyes closed were extracted. The cortical source signals of 84 Brodmann areas were calculated using the exact low resolution brain electromagnetic tomography (eLORETA) inverse solution by LORETA-KEY. Phase Lag Index (PLI) matrices were then obtained and graph and relative band power (RBP) analyses were performed.
Compared with healthy controls, functional connectivity (FC) in the delta, theta, beta 1 and beta 2 bands significantly increased within the 84 cortical source signals of anti-NMDAR encephalitis patients ( < 0.05) and scalp FC in the alpha band decreased within the 19 electrodes. Additionally, the anti-NMDAR encephalitis group exhibited higher local efficiency and clustering coefficient compared to the healthy control group in the four bands. The slowing band RBP increased while the fast band RBP decreased in multiple-lobes and some of these changes in RBP were correlated with the modified Rankin Scale (mRS) and Mini-mental State Examination (MMSE) in anti-NMDAR encephalitis patients.
This study further deepens the understanding of related changes in the abnormal brain network and power spectrum of anti-NMDA receptor encephalitis. The decreased scalp alpha FC may indicate brain dysfunction, while the increased source beta FC may indicate a compensatory mechanism for brain function in anti-NMDAR encephalitis patients. These findings extend understanding of how the brain FN changes from a cortical source perspective. Further studies are needed to detect correlations between altered FNs and clinical features and characterize their potential value for the management of anti-NMDAR encephalitis.
功能磁共振成像研究已认识到抗N-甲基-D-天冬氨酸受体（NMDAR）脑炎中功能网络（FN）的改变。然而，很少有使用脑电图（EEG）的研究来探索抗NMDAR脑炎中可能的FN变化。在本研究中，目的是探索抗NMDAR脑炎患者的FN变化。
对29例抗NMDAR脑炎患者和29例年龄及性别匹配的健康对照（HC）进行19导EEG检查评估。为每位参与者提取5个闭眼静息状态EEG的10秒时段。使用LORETA-KEY通过精确低分辨率脑电磁断层扫描（eLORETA）逆解计算84个Brodmann区域的皮质源信号。然后获得相位滞后指数（PLI）矩阵并进行图形和相对频段功率（RBP）分析。
与健康对照相比，抗NMDAR脑炎患者的84个皮质源信号中，δ、θ、β1和β2频段的功能连接（FC）显著增加（<0.05），19个电极处α频段的头皮FC降低。此外，抗NMDAR脑炎组在四个频段中与健康对照组相比表现出更高的局部效率和聚类系数。多叶中慢频段RBP增加而快频段RBP降低，并且抗NMDAR脑炎患者中这些RBP变化中的一些与改良Rankin量表（mRS）和简易精神状态检查表（MMSE）相关。
本研究进一步加深了对抗NMDAR受体脑炎异常脑网络和功率谱相关变化的理解。头皮α频段FC降低可能表明脑功能障碍，而源β频段FC增加可能表明抗NMDAR脑炎患者脑功能的一种代偿机制。这些发现从皮质源角度扩展了对脑FN变化的理解。需要进一步研究以检测改变的FN与临床特征之间的相关性，并表征它们在抗NMDAR脑炎管理中的潜在价值。
