Clinical Investigation
Characteristics of brain glucose metabolism in patients with anti-N-methyl-D-aspartate receptor encephalitis underlying different inducing factors
Ge Jingjie, Deng Bo, Li Ming, Guan Yihui, Bao Weiqi, Wu Ping, Lin Huamei, Chen Xiangjun, Zuo Chuantao
Published 2022-09-25
Cite as Chin J Nucl Med Mol Imaging, 2022, 42(9): 513-517. DOI: 10.3760/cma.j.cn321828-20210327-00085
Abstract
ObjectiveTo investigate characteristics and differences of cerebral glucose metabolism in patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis from the perspective of different trigger factors of antibodies.
MethodsA total of 15 patients (8 males, 7 females, age (30.5±17.7) years) with anti-NMDAR encephalitis between January 2016 and January 2019 in Huashan Hospital, Fudan University were recruited retrospectively. All patients underwent resting state cerebral 18F-FDG PET imaging. The characteristics of brain glucose metabolism were analyzed, and the SUV ratio (SUVR) was semi-quantitatively compared with that in 12 healthy subjects (HS; 7 males, 5 females, age (51.5±9.6) years). Independent-sample t test was used to analyze the data.
ResultsAmong 15 patients, 5 patients were viral encephalitis-related anti-NMDAR encephalitis, showing focal decreased metabolism in unilateral temporal lobe or basal ganglia (SUVR: patients: 0.659±0.219; HS: 1.754±0.203; t=-9.58, P<0.001), with increased metabolism in contralateral temporal lobe or basal ganglia (SUVR: patients: 2.275±0.244; HS: 1.960±0.227; t=2.55, P=0.022) in 18F-FDG PET imaging. Six patients were cryptogenic anti-NMDAR encephalitis, showing asymmetric increased metabolism in frontal, temporal, parietal and basal ganglia (SUVR: patients: 2.482±0.395; HS: 1.754±0.203; t=5.23, P<0.001), with decreased metabolism in bilateral occipital lobes. The remaining 4 cases were paraneoplastic origin accompanied by teratoma, showing increased metabolism in bilateral temporal and basal ganglia (SUVR: patient: 2.359±0.181; HS: 1.960±0.227; t=3.16, P=0.007), with mild decreased metabolism in bilateral occipital lobe.
ConclusionsThe abnormal changes of cerebral glucose metabolism in patients with anti-NMDAR encephalitis can be divided into at least three patterns according to different trigger factors. A comprehensive understanding of these characteristic metabolic changes is helpful for detecting disease, and may provide potential value in indicating different causes.
Key words:
Anti-N-methyl-D-aspartate receptor encephalitis; Positron-emission tomography; Tomography, X-ray computed; Fluorodeoxyglucose F18
Contributor Information
Ge Jingjie
PET Center, Huashan Hospital, Fudan University, Shanghai 200235, China
Deng Bo
Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
Li Ming
PET Center, Huashan Hospital, Fudan University, Shanghai 200235, China
Guan Yihui
PET Center, Huashan Hospital, Fudan University, Shanghai 200235, China
Bao Weiqi
PET Center, Huashan Hospital, Fudan University, Shanghai 200235, China
Wu Ping
PET Center, Huashan Hospital, Fudan University, Shanghai 200235, China
Lin Huamei
PET Center, Huashan Hospital, Fudan University, Shanghai 200235, China
Chen Xiangjun
Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
Zuo Chuantao
PET Center, Huashan Hospital, Fudan University, Shanghai 200235, China
