Chen Qiqi, Ma Yun, Li Zonghong, Yu Chuanyong, Wang Xiaoshan, Miao Ailiang
Department of Magnetoencephalography, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
Department of Neurology, Affiliated Suqian First People's Hospital of Nanjing Medical University, Suqian, China.
J Neurol. 2025 Aug 2;272(8):551. doi: 10.1007/s00415-025-13302-x.
This study aimed to elucidate the distributions of abnormal activities, as well as the functional connectivity and topological properties of brain networks, in patients diagnosed with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.
From February 2016 to February 2025, acute-phase magnetoencephalography (MEG) data were successfully acquired from 16 patients diagnosed with anti-NMDAR encephalitis at the Affiliated Brain Hospital of Nanjing Medical University. MEG was employed to evaluate the power spectral density (PSD) across multiple frequency bands. Further analysis concentrated on functional connectivity and the topological characteristics of brain networks in order to identify distinctive neurophysiological features associated with the condition.
During the acute phase, the PSD in the delta band (1-3 Hz) showed greater power in posterior regions and lower power in anterior regions, with the highest energy concentrated bilaterally in the occipitoparietal and temporal areas. In the theta band (5-7 Hz), the PSD was predominantly localized to the bilateral occipitoparietal regions. The beta1 band (13-20 Hz) was primarily distributed in the right temporo-occipitoparietal regions, while the beta2 band (20-30 Hz) was predominantly distributed in the left temporal, occipitoparietal, and certain frontal regions. Functional connectivity analysis revealed enhanced connections between the left caudal anterior cingulate (CAC_L) and the left superior parietal lobe in the delta and theta bands. Increased connectivity was also observed between the left frontal pole and Precuneus_L, CAC_L, and the left superior temporal gyrus (STG_L)in the theta and beta2 bands. Furthermore, enhanced connectivity between STG_L and Pericalcarine_R was observed in the theta, beta2, and gamma bands. Patients with anti-NMDAR encephalitis demonstrated significantly reduced global efficiency and notable increases in average path length, local efficiency, and clustering coefficient in multiple bands, suggesting local clustering of brain networks during the acute phase.
Alterations in PSD distribution and brain networks across different frequency bands may provide valuable insights into the electrophysiological changes observed in the brains of anti-NMDAR encephalitis patients. Furthermore, these findings may offer valuable mechanistic insights that could contribute to the development of future diagnostic strategies.
本研究旨在阐明抗N-甲基-D-天冬氨酸受体（NMDAR）脑炎患者大脑异常活动的分布情况，以及脑网络的功能连接性和拓扑特性。
2016年2月至2025年2月期间，成功获取了南京医科大学附属脑科医院16例诊断为抗NMDAR脑炎患者的急性期脑磁图（MEG）数据。采用MEG评估多个频段的功率谱密度（PSD）。进一步分析集中在脑网络的功能连接性和拓扑特征上，以识别与该疾病相关的独特神经生理特征。
急性期，δ频段（1-3Hz）的PSD在后脑区域显示出更高的功率，在前脑区域功率较低，最高能量集中在双侧枕顶叶和颞叶区域。在θ频段（5-7Hz），PSD主要定位于双侧枕顶叶区域。β1频段（13-20Hz）主要分布在右侧颞枕顶叶区域，而β2频段（20-30Hz）主要分布在左侧颞叶、枕顶叶和某些额叶区域。功能连接性分析显示，在δ和θ频段，左侧尾侧前扣带回（CAC_L）与左侧顶上叶之间的连接增强。在θ和β2频段，还观察到左侧额极与楔前叶、CAC_L和左侧颞上回（STG_L）之间的连接增加。此外，在θ、β2和γ频段观察到STG_L与右侧距状裂周围之间的连接增强。抗NMDAR脑炎患者在多个频段的全局效率显著降低，平均路径长度、局部效率和聚类系数显著增加，表明急性期脑网络存在局部聚类。
不同频段PSD分布和脑网络的改变可能为抗NMDAR脑炎患者大脑中观察到的电生理变化提供有价值的见解。此外，这些发现可能提供有价值的机制性见解，有助于未来诊断策略的发展。
