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评估抗N-甲基-D-天冬氨酸受体脑炎神经功能缺损程度的GTE评分

GTE score on evaluating the degree of neurological impairment in anti-NMDA receptor encephalitis.

作者信息

Pan Xiaoying, Zhang Yuefeng, Huang Jiayi, Chen Guohua

机构信息

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

Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China.

出版信息

Sci Rep. 2025 Apr 22;15(1):13875. doi: 10.1038/s41598-025-97439-9.

Abstract

This study mainly analyzed the EEG changes and the development of neurological impairment at different stages of the disease, and explored the clinical role of the Grand Total EEG score (GTE score) in evaluating the degree of neurological impairment function damage in anti-NMDA receptor encephalitis. The GTE scores of patients with anti-NMDA receptor encephalitis at different disease stages and the diagnostic validity of the GTE scores for evaluating the degree of neurological impairment were analyzed. 153 EEG cases were included in this study, with a course of 2 to 960 days. The abnormal EEG rates were 92% in the acute phase, 83% in the recovery phase, 76% in the short-term prognosis phase, and 30% in the long-term prognosis phase. The GTE score: acute phase=(5, 0-15); recovery phase=(2, 0-14); short-term prognosis phase= (2, 0-9); long-term prognosis phase = (0, 0-6). When the total GTE score is 5.5, the patient was more likely to have moderate to severe neurological impairment (mRS = 4), with sensitivity and specificity > 0.9. When the total GTE score was 7.5, the patient was more likely to have severe neurological impairment (mRS = 5), with sensitivity and specificity > 0.9. GTE score has a high diagnostic efficacy for the rating of neurological impairment. The total GTE score was superior to the assessment of neurological damage degree solely from background activity frequency or diffuse slow wave activity.

摘要

本研究主要分析了疾病不同阶段的脑电图(EEG)变化及神经功能缺损的发展情况,探讨了脑电图总分(GTE评分)在评估抗N-甲基-D-天冬氨酸(NMDA)受体脑炎神经功能缺损程度中的临床作用。分析了抗NMDA受体脑炎患者在不同疾病阶段的GTE评分及GTE评分对评估神经功能缺损程度的诊断效度。本研究纳入153例EEG病例,病程为2至960天。急性期EEG异常率为92%,恢复期为83%,近期预后阶段为76%,远期预后阶段为30%。GTE评分:急性期=(5,0 - 15);恢复期=(2,0 - 14);近期预后阶段=(2,0 - 9);远期预后阶段=(0,0 - 6)。当GTE总分≥5.5时,患者更有可能出现中度至重度神经功能缺损(改良Rankin量表[mRS]=4),敏感性和特异性>0.9。当GTE总分≥7.5时,患者更有可能出现重度神经功能缺损(mRS = 5),敏感性和特异性>0.9。GTE评分对神经功能缺损分级具有较高的诊断效能。GTE总分优于单纯根据背景活动频率或弥漫性慢波活动对神经损伤程度的评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97a6/12015232/364384e5c482/41598_2025_97439_Fig1_HTML.jpg

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