CSF Indices in Autoimmune Encephalitis: Promising Predictors of Treatment Response. (5th December 2022)

• Record Type: Journal Article
• Authors: Popova, Ekaterina; Nair, Pranav; Mathai, Annamma; Sasikumar, Sruthi; Gopinath, Siby; Nambiar, Vivek; Kumar, Anand; Umesh, Saraf Udit; Leelamaniamma, Jyothi; Kannoth, Sudheeran
• Is Part Of: Neurology. Volume 99:Number 23(2022)Supplement 2
• Page Start: S47
• Page End: S48
• Publication Date: 2022-12-05
• Subjects: Neurology -- Periodicals; Neurology -- Periodicals; Neurologie -- Périodiques; 616.8
• DOI: 10.1212/01.wnl.0000903388.67855.1f
• Languages: English
• ISSNs: 0028-3878

Abstract

Abstract : Objective: To study CSF Indices and their association with prognosis of autoimmune encephalitis. Background: Till date, there is no published data on use of CSF indices in diagnosing or prognosticating of autoimmune encephalitis. Design/Methods: This retrospective, single-center (AIMS, Kochi, India) cohort study included 60 adult patients with autoimmune encephalitis who were first admitted from August 2016 till November 2021. We used a univariate binary logistic regression for the entire cohort (n = 60) or the cohort of seronegative cases (n = 54) and a two-tailed Fisher's exact test for a small group of seropositive cases (n = 6). A Chi-square test was performed to describe the results in rare cases if logistic regression failed to work. Results: In the entire cohort (n = 60) a statistically significant association was found between a good fast treatment response and a total count of cells in the CSF more than 4 cells/mm 3 (OR 4.571, 95% CI 1.31–15.956, p = 0.017), IgG Local Synthesis (OR 7.273, 95% CI 1.562–33.863, p = 0.011), and Integrative Parameter of Local IgG Synthesis proposed by Ziadie M. et al. (OR 5.318, 95% CI 1.271–22.250, p = 0.022). Good fast response was defined as an improvement with single agent from the first line therapy by mRS-9Q of at least 3 points in case of severe disease and at least 2 points in case of moderately severe disease at the time of discharge. Higher Albumin Index values associated with higher odds of having poor GCS Score (OR 1.165, 95% CI 1.011–1.343, p = 0.035). In the cohort of seronegative cases (n = 54) we obtained similar results. In the cohort of seropositive cases (n = 6), none of the patients had a good fast response. Conclusions: In our research, evidence of Local IgG Synthesis in CNS and CSF total cell count more than 4 cells/mm 3 showed association with a good and fast treatment response in patients with autoimmune encephalitis.