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Cognitive dysfunction is the core symptom of patients with anti-NMDA receptor (NMDAR) encephalitis
.
The impairment of cognitive function greatly affects the quality of life, potential academic and professional achievements, and social interactions of young patients
Following the first description of NMDAR antibodies 13 years ago, clinical studies have begun to investigate the long-term prognosis of patients with NMDAR encephalitis
.
Large-scale studies assess the prognosis of the nervous system based on the modified Rankin Scale (mRS) and cognitive screening results, such as the Mini Mental State Examination (MMSE), with a follow-up period of up to 24 months
Screening is characterized by being relatively independent in most activities of daily living, but still has a slight disability.
In this way, Josephine Heine and others of the University of Berlin, Germany, conducted a comprehensive longitudinal neuropsychological and clinical evaluation of 40 patients with NMDAR encephalitis at two time points
.
The purpose is:
(1) To systematically investigate the cognitive results of a large sample of patients with NMDAR encephalitis;
(2) To describe the trajectory of cognitive deficits during the 2-year follow-up;
(3) To explore the relationship between the clinical nervous system and cognitive recovery;
(4) Determine the clinical predictors of long-term cognitive outcomes;
(5) Assess the time course of cognitive function recovery in major cognitive domains
.
They conducted a standardized comprehensive neuropsychological assessment of 43 patients with NMDAR encephalitis at 2.
3 years and 4.
9 years (median) after the onset
All patients had persistent cognitive deficits 2.
3 years after the onset, and more than 80% of patients had moderate or severe impairment
Delayed treatment, higher disease severity, and longer acute phase are predictors of impaired cognitive outcomes
.
.
The recovery process is related to time.
There is greater progress in the early after the acute phase, and it is possible to improve within a few years after the onset of the disease
The important significance of this study lies in the discovery: cognitive impairment is the main factor leading to the long-term onset of NMDAR encephalitis, and it persists after the recovery of neurological function
.
Nevertheless, in the years after the acute phase, cognitive ability may still be improved and should be supported by continuous cognitive rehabilitation
Cognitive impairment is the main factor leading to the long-term onset of NMDAR encephalitis.
Original source:
Heine J, Kopp UA, Klag J, Ploner CJ, Prüss H, Finke C.
Long-term cognitive outcome in anti-NMDA receptor encephalitis.
_Ann Neurol_.
Published online September 30, 2021:ana.
26241.
doi:10.
1002 /ana.
26241 Long‐term cognitive outcome in anti‐NMDA receptor encephalitis.
_Ann Neurol_.
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