Imaging of autoimmune encephalitis--Relevance for clinical practice and hippocampal function

Neuroscience. 2015 Nov 19;309:68-83. doi: 10.1016/j.neuroscience.2015.05.037. Epub 2015 May 23.

Abstract

The field of autoimmune encephalitides associated with antibodies targeting cell-surface antigens is rapidly expanding and new antibodies are discovered frequently. Typical clinical presentations include cognitive deficits, psychiatric symptoms, movement disorders and seizures and the majority of patients respond well to immunotherapy. Pathophysiological mechanisms and clinical features are increasingly recognized and indicate hippocampal dysfunction in most of these syndromes. Here, we review the neuroimaging characteristics of autoimmune encephalitides, including N-methyl-d-aspartate (NMDA) receptor, leucine-rich glioma inactivated 1 (LGI1), contactin-associated protein-like 2 (CASPR2) encephalitis as well as more recently discovered and less frequent forms such as dipeptidyl-peptidase-like protein 6 (DPPX) or glycine receptor encephalitis. We summarize findings of routine magnetic resonance imaging (MRI) investigations as well as (18)F-fluoro-2-deoxy-d-glucose (FDG)-positron emission tomography (PET) and single photon emission tomography (SPECT) imaging and relate these observations to clinical features and disease outcome. We furthermore review results of advanced imaging analyses such as diffusion tensor imaging, volumetric analyses and resting-state functional MRI. Finally, we discuss contributions of these neuroimaging observations to the understanding of the pathophysiology of autoimmune encephalitides.

Keywords: MRI; PET; autoimmune encephalitis; hippocampus; imaging; limbic encephalitis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Encephalitis / diagnostic imaging*
  • Encephalitis / pathology*
  • Encephalitis / physiopathology
  • Hashimoto Disease / diagnostic imaging*
  • Hashimoto Disease / pathology*
  • Hashimoto Disease / physiopathology
  • Hippocampus / diagnostic imaging*
  • Hippocampus / pathology*
  • Hippocampus / physiopathology
  • Humans
  • Neuroimaging / methods*
  • Radionuclide Imaging

Supplementary concepts

  • Hashimoto's encephalitis