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Background and objectives <p>To identify factors predictive of a favourable modified Rankin score (mRS) at 12 months in patients with autoimmune encephalitis (AE). To evaluate predictors of a binary composite clinical-functional outcome measure, encompassing mRS, drug-resistant epilepsy (DRE) and memory impairment, at 12 months.</p> Methods <p>Univariable and multivariable logistic regression analyses for predictors of a favourable mRS (i.e. mRS ≤ 2) and a composite clinical-functional outcome at 12 months were used.</p> Results <p>A total of 231 patients with AE were recruited. Multivariable logistic regression identified factors predictive of reduced odds of favourable mRS at 12 months were older age (OR 0.97; 95% CI 0.95, 0.98; <i>p</i> &lt; 0.001), T2/FLAIR hyperintensity on initial MRI (OR 0.27; 95% CI 0.13, 0.56; <i>p</i> &lt; 0.001), RSE (OR 0.17; 95% CI 0.06, 0.52; <i>p</i> = 0.002) and first-line immunotherapy failure (OR 0.18; 95% CI 0.09, 0.37; <i>p</i> &lt; 0.001). Anti-LGI1 antibody-mediated encephalitis relative to other subtypes (OR 4.46; 95% CI 1.55, 12.80; <i>p</i> = 0.006) was associated with a better 12-month mRS. We found concordant associations for a composite outcome at 12 months, with the addition of a diagnosis of definite autoimmune limbic encephalitis (AILE) predicting a poor outcome.</p> Discussion <p>Older age, MRI T2/FLAIR hyperintensity, RSE and first-line immunotherapy failure predicted worse mRS and composite clinical-functional outcome at 12 months, while a diagnosis of anti-LGI1 antibody-mediated encephalitis was associated with favourable outcomes. Our data highlight acute clinical factors predictive of a more severe clinical and functional course at 12 months.</p>

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Multimodal prognostication of autoimmune encephalitis: an Australian autoimmune encephalitis consortium study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月25日

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  • Nabil Seery,
  • Robb Wesselingh,
  • Paul Beech,
  • James Broadley,
  • Sarah Griffith,
  • Tiffany Rushen,
  • James Beharry,
  • Caleb Tan,
  • Noushin Chiniforoush,
  • Laurie McLaughlin,
  • Liora ter Horst,
  • Mirasol Forcadela,
  • Tracie Tan,
  • Christina Kazzi,
  • Cassie Nesbitt,
  • Katherine Buzzard,
  • Andrew Duncan,
  • Amy Halliday,
  • Wendyl D’Souza,
  • Yang Tran,
  • Anneke Van Der Walt,
  • Genevieve Skinner,
  • Andrew Swayne,
  • Charles B. Malpas,
  • Amy Brodtmann,
  • David Gillis,
  • Bruce Taylor,
  • Ernest G. Butler,
  • Tomas Kalincik,
  • Udaya Seneviratne,
  • Richard Macdonell,
  • Stefan Blum,
  • Sudarshini Ramanathan,
  • Stephen W. Reddel,
  • Todd A. Hardy,
  • Terence J. O’Brien,
  • Paul Sanfilippo,
  • Helmut Butzkueven,
  • Mastura Monif

摘要

Background and objectives

To identify factors predictive of a favourable modified Rankin score (mRS) at 12 months in patients with autoimmune encephalitis (AE). To evaluate predictors of a binary composite clinical-functional outcome measure, encompassing mRS, drug-resistant epilepsy (DRE) and memory impairment, at 12 months.

Methods

Univariable and multivariable logistic regression analyses for predictors of a favourable mRS (i.e. mRS ≤ 2) and a composite clinical-functional outcome at 12 months were used.

Results

A total of 231 patients with AE were recruited. Multivariable logistic regression identified factors predictive of reduced odds of favourable mRS at 12 months were older age (OR 0.97; 95% CI 0.95, 0.98; p < 0.001), T2/FLAIR hyperintensity on initial MRI (OR 0.27; 95% CI 0.13, 0.56; p < 0.001), RSE (OR 0.17; 95% CI 0.06, 0.52; p = 0.002) and first-line immunotherapy failure (OR 0.18; 95% CI 0.09, 0.37; p < 0.001). Anti-LGI1 antibody-mediated encephalitis relative to other subtypes (OR 4.46; 95% CI 1.55, 12.80; p = 0.006) was associated with a better 12-month mRS. We found concordant associations for a composite outcome at 12 months, with the addition of a diagnosis of definite autoimmune limbic encephalitis (AILE) predicting a poor outcome.

Discussion

Older age, MRI T2/FLAIR hyperintensity, RSE and first-line immunotherapy failure predicted worse mRS and composite clinical-functional outcome at 12 months, while a diagnosis of anti-LGI1 antibody-mediated encephalitis was associated with favourable outcomes. Our data highlight acute clinical factors predictive of a more severe clinical and functional course at 12 months.