Corticospinal tract hyperintensity in patients with LGI1-antibody encephalitis and other central nervous system disorders with neuroglial antibodies

J Neuroimmunol. 2024 May 15:390:578346. doi: 10.1016/j.jneuroim.2024.578346. Epub 2024 Apr 17.

Abstract

The frequency of corticospinal tract (CST) T2/FLAIR hyperintensity in disorders with neuroglial antibodies is unclear. Herein, we retrospectively reviewed brain MRIs of 101 LGI1-antibody encephalitis patients, and observed CST hyperintensity in 30/101 (30%). It was mostly bilateral (93%), not associated with upper motor neuron signs/symptoms (7%), and frequently decreased over time (39%). In a systematic review including patients with other neuroglial antibodies, CST hyperintensity was reported in 110 with neuromyelitis optica (94%), myelin oligodendrocyte glycoprotein-associated disease (2%), Ma2-antibody (3%) and GAD65-antibody paraneoplastic neurological syndrome (1%). CST hyperintensity is not an infrequent finding in LGI1-Ab encephalitis and other disorders with neuroglial antibodies.

Keywords: Autoimmune encephalitis; Corticospinal tracts; Inflammatory diseases; LGI1.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Autoantibodies* / blood
  • Autoantibodies* / immunology
  • Central Nervous System Diseases / diagnostic imaging
  • Central Nervous System Diseases / immunology
  • Encephalitis* / diagnostic imaging
  • Encephalitis* / immunology
  • Female
  • Humans
  • Intracellular Signaling Peptides and Proteins* / immunology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neuroglia / immunology
  • Neuroglia / pathology
  • Pyramidal Tracts* / diagnostic imaging
  • Pyramidal Tracts* / immunology
  • Pyramidal Tracts* / pathology
  • Retrospective Studies
  • Young Adult

Substances

  • Autoantibodies
  • LGI1 protein, human
  • Intracellular Signaling Peptides and Proteins