Raia A Blum1, Amanda R Tomlinson2, Nathalie Jetté3, Churl-Su Kwon4, Ava Easton5, Anusha K Yeshokumar6. 1. Department of Neurology, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, New York, NY 10029, USA. Electronic address: Raia.Blum@icahn.mssm.edu. 2. Department of Neurology, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, New York, NY 10029, USA. Electronic address: Amanda.Tomlinson@icahn.mssm.edu. 3. Department of Neurology, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, New York, NY 10029, USA. Electronic address: Nathalie.Jette@mssm.edu. 4. Department of Neurology, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, New York, NY 10029, USA. Electronic address: Churlsu.Kwon@mssm.edu. 5. Department of Clinical Infection, Microbiology and Immunology, Institute of Infection and Global Health, University of Liverpool, 8 West Derby Street, Liverpool L69 7BE, UK; The Encephalitis Society, 32 Castlegate, Malton YO17 7DT, North Yorkshire, UK. Electronic address: Ava@encephalitis.info. 6. Department of Neurology, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, New York, NY 10029, USA; Autoimmune Encephalitis Alliance, 920 Urban Avenue, Durham, NC 27701, USA. Electronic address: Anusha.Yeshokumar@mssm.edu.
Abstract
PURPOSE: The purpose of this study was to assess long-term psychosocial outcomes of anti-N-methyl-d-aspartate (NMDA) receptor encephalitis (anti-NMDARE). METHODS: Adolescents and adults with self-reported anti-NMDARE were invited to complete an online survey distributed by relevant patient organizations. Demographic and clinical information was collected, including the diagnoses initially given for anti-NMDARE symptoms and posthospital care received. Patient-Reported Outcomes Measurement Information System (PROMIS) Psychosocial Impact Illness - Negative short form (Negative PSII) was administered to assess psychosocial outcome of anti-NMDARE. Associations between clinical factors and psychosocial outcomes were evaluated. RESULTS: Sixty-one individuals with anti-NMDARE age 15 years and above participated. Mean age was 33.7 years (standard deviation [SD]: 12.8), and participants were predominantly female (90.2%, n = 55). Mean T-score on PROMIS Negative PSII was 60.7, >1 SD higher (worse psychosocial function) than that of the provided normalized sample enriched for chronic illness (50, SD: 10). Initial misdiagnosis of anti-NMDARE symptoms was associated with decreased odds (odds ratio [OR]: 0.11, p < 0.05), and follow-up with a psychiatrist after hospitalization with increased odds (OR: 8.46, p < 0.05), of return to work/school after illness. Younger age of symptom onset and presence of ongoing neuropsychiatric issues were predictive of worse Negative PSII scores (p < 0.05). CONCLUSION: Individuals with anti-NMDARE demonstrate poor psychosocial outcomes, yet there are no current standards for long-term assessment or management of such symptoms in this population. These findings highlight the need for use of more comprehensive outcome measures that include assessment of psychosocial function and the importance of developing interventions that address this domain for individuals with anti-NMDARE.
PURPOSE: The purpose of this study was to assess long-term psychosocial outcomes of anti-N-methyl-d-aspartate (NMDA) receptor encephalitis (anti-NMDARE). METHODS: Adolescents and adults with self-reported anti-NMDARE were invited to complete an online survey distributed by relevant patient organizations. Demographic and clinical information was collected, including the diagnoses initially given for anti-NMDARE symptoms and posthospital care received. Patient-Reported Outcomes Measurement Information System (PROMIS) Psychosocial Impact Illness - Negative short form (Negative PSII) was administered to assess psychosocial outcome of anti-NMDARE. Associations between clinical factors and psychosocial outcomes were evaluated. RESULTS: Sixty-one individuals with anti-NMDARE age 15 years and above participated. Mean age was 33.7 years (standard deviation [SD]: 12.8), and participants were predominantly female (90.2%, n = 55). Mean T-score on PROMIS Negative PSII was 60.7, >1 SD higher (worse psychosocial function) than that of the provided normalized sample enriched for chronic illness (50, SD: 10). Initial misdiagnosis of anti-NMDARE symptoms was associated with decreased odds (odds ratio [OR]: 0.11, p < 0.05), and follow-up with a psychiatrist after hospitalization with increased odds (OR: 8.46, p < 0.05), of return to work/school after illness. Younger age of symptom onset and presence of ongoing neuropsychiatric issues were predictive of worse Negative PSII scores (p < 0.05). CONCLUSION: Individuals with anti-NMDARE demonstrate poor psychosocial outcomes, yet there are no current standards for long-term assessment or management of such symptoms in this population. These findings highlight the need for use of more comprehensive outcome measures that include assessment of psychosocial function and the importance of developing interventions that address this domain for individuals with anti-NMDARE.
Authors: Anusha Yeshokumar; Eliza Gordon-Lipkin; Ana Arenivas; Mark Rosenfeld; Kristina Patterson; Raia Blum; Brenda Banwell; Arun Venkatesan; Eric Lancaster; Jessica Panzer; John Probasco Journal: Neurol Neuroimmunol Neuroinflamm Date: 2022-07-06
Authors: Gregory S Day; Melanie Y Yarbrough; Peter Körtvelyessy; Harald Prüss; Robert C Bucelli; Marvin J Fritzler; Warren Mason; David F Tang-Wai; Claude Steriade; Julien Hébert; Rachel L Henson; Elizabeth M Herries; Jack H Ladenson; A Sebastian Lopez-Chiriboga; Neill R Graff-Radford; John C Morris; Anne Fagan Journal: Neurology Date: 2021-04-01 Impact factor: 9.910
Authors: Luisa A Diaz-Arias; Anusha Kierty Yeshokumar; Brittany Glassberg; James F Sumowski; Ava Easton; John C Probasco; Arun Venkatesan Journal: Neurol Neuroimmunol Neuroinflamm Date: 2021-08-13