Liu Fei-Xiang, Qiu Qi, Yan Feng, Feng Yan-Chen, Wei Hong-Hui, Li Xia
Shanghai Mental Health Center, Shanghai Jiaotong University, School of Medicine, Shanghai, People's Republic of China.
Department of Psychiatry and Psychology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, People's Republic of China.
Neuropsychiatr Dis Treat. 2024 Dec 12;20:2457-2464. doi: 10.2147/NDT.S457591. eCollection 2024.
N-methyl-D-aspartate receptor encephalitis (NMDARE) presents serious neurological manifestations such as reduced consciousness, seizures, and movement disorders, which can escalate to coma or severe autonomic dysfunction. Treatment typically involves immunotherapy and tumor removal to mitigate the autoimmune response. Timely diagnosis and treatment are critical to prevent severe neurological impairment or death. Memantine, an NMDA receptor antagonist, has shown variable effectiveness in treating NMDARE according to several case reports, yet comprehensive analyses remain scarce. This mini review draws on five literature sources and eight case studies from databases including PubMed, Embase, the Cochrane Library, and Web of Science, highlighting both the potential and risks of memantine as an adjunct therapy. We explore how memantine may reduce symptoms by blocking excessive NMDA receptor (NMDAR) antibody binding, while potentially worsening symptoms by reducing extracellular NMDAR availability, thus impairing neuronal communication. This dual effect calls for further investigation into the optimal use and duration of memantine treatment in NMDARE management.
N-甲基-D-天冬氨酸受体脑炎（NMDARE）会出现严重的神经学表现，如意识减退、癫痫发作和运动障碍，这些症状可能会发展为昏迷或严重的自主神经功能障碍。治疗通常包括免疫疗法和肿瘤切除，以减轻自身免疫反应。及时诊断和治疗对于预防严重的神经功能损害或死亡至关重要。根据几份病例报告，美金刚作为一种NMDA受体拮抗剂，在治疗NMDARE方面显示出不同的疗效，但全面的分析仍然很少。这篇小型综述借鉴了包括PubMed、Embase、Cochrane图书馆和科学网在内的数据库中的五篇文献来源和八个病例研究，强调了美金刚作为辅助治疗的潜力和风险。我们探讨了美金刚如何通过阻断过量的NMDA受体（NMDAR）抗体结合来减轻症状，同时又可能通过降低细胞外NMDAR的可用性而加重症状，从而损害神经元通讯。这种双重作用需要进一步研究美金刚在NMDARE治疗中的最佳使用方法和疗程。
