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Patient characteristics and outcome associations in AMPA receptor encephalitis.

ABSTRACT: Antibody-mediated encephalitis defines a class of diseases wherein antibodies directed at cell-surface receptors are associated with behavioral and cognitive disturbances. One such recently described encephalitis is due to antibodies directed at alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors (AMPAR). This entity is exceptionally rare and its clinical phenotype incompletely described. We present findings from two cases of AMPAR encephalitis that exemplify variability in the disease spectrum, and summarize findings in published cases derived from a systematic literature review. When all patients are considered together, the presence of psychiatric symptoms at presentation portended a poor outcome and was associated with the presence of a tumor. Furthermore, we provide evidence to suggest that the topography of magnetic resonance imaging abnormalities in reported cases mirrors the distribution of AMPARs in the human brain. The potential for neurological improvement following immunomodulatory therapy together with the favorable outcome reported in most cases emphasizes the importance of testing for autoantibodies against neuronal cell-surface proteins, including AMPAR, in patients with clinical and neuroimaging findings suggestive of autoimmune encephalitis. Close attention to the clinical phenotype may inform the presence of malignancy and long-term prognosis.

SUBMITTER: Laurido-Soto O

PROVIDER: S-EPMC6367044 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Patient characteristics and outcome associations in AMPA receptor encephalitis.

Laurido-Soto Osvaldo O Brier Matthew R MR Simon Laura E LE McCullough Austin A Bucelli Robert C RC Day Gregory S GS

Journal of neurology 20181217 2

Antibody-mediated encephalitis defines a class of diseases wherein antibodies directed at cell-surface receptors are associated with behavioral and cognitive disturbances. One such recently described encephalitis is due to antibodies directed at alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors (AMPAR). This entity is exceptionally rare and its clinical phenotype incompletely described. We present findings from two cases of AMPAR encephalitis that exemplify variability in the di ...[more]

PMID: 30560455

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Project description:BackgroundGoal setting is linked to person-centred care and is a core component in physiotherapy, but the associations between goal classes, patient characteristics and outcome measures for musculoskeletal disorders has not been investigated. The study's purpose was to examine 1) how goals used in clinical practice for patients with musculoskeletal disorders (MSD) are distributed in classes based on ICF, 2) if goal classes were associated with patient characteristics and 3) whether goal classes were associated with treatment outcome.MethodsData analysis from a longitudinal observational study (N?=?2591). Goals were classified in symptom, function/structure, activity/participation and non-classifiable. Associations between patient characteristics and goal classes were examined using x2 and one-way ANOVA. Association between goal classes and outcomes were examined using multiple logistic and linear regression models. Outcomes are reported at 3?months or end of treatment if prior to 3?months.ResultsThere was a high variability in goals used for patients with MSD. 17% had symptom goals, 32.3% function/structure, 43.4% activity/participation and 7.4% non-classifiable goals. We found significant associations between goal classes and age, gender, severity, region of pain/diagnosis and emotional distress (all p?<?.001). Activity/participation goals were associated with better outcomes on GPE (OR 1.80, 95% CI 1.23-2.66). Non-classifiable goal was associated with poorer outcomes on pain intensity (B .87, 95% CI .32-1.43).ConclusionThere is an association between goal classes and patient characteristics. Including activity/participation in the main goal was associated with better outcomes for GPE and having a non-classifiable goal was associated with poorer outcomes for pain intensity.Trial registrationThe project is approved by the Regional committee for Medical and Health Research Ethics in Norway (REC no. 2013/2030). https://clinicaltrials.gov/ct2/show/NCT03626389 .

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Patient characteristics and outcome associations in AMPA receptor encephalitis.

Publications

Patient characteristics and outcome associations in AMPA receptor encephalitis.

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