Neuropsychological and FDG-PET profiles in VGKC autoimmune limbic encephalitis

Alessandra Dodich, Chiara Cerami, Sandro Iannaccone, Alessandra Marcone, Pierpalolo Alongi, Chiara Crespi, Nicola Canessa, Francesca Andreetta, Andrea Falini, Stefano Cappa, Daniela Perani

Research output: Contribution to journalArticle

Abstract

Background Limbic encephalitis (LE) is characterized by an acute or subacute onset with memory impairments, confusional state, behavioral disorders, variably associated with seizures and dystonic movements. It is due to inflammatory processes that selectively affect the medial temporal lobe structures. Voltage-gate potassium channel (VGKC) autoantibodies are frequently observed. In this study, we assessed at the individual level FDG-PET brain metabolic dysfunctions and neuropsychological profiles in three autoimmune LE cases seropositive for neuronal VGKC-complex autoantibodies. Materials and methods LGI1 and CASPR2 potassium channel complex autoantibody subtyping was performed. Cognitive abilities were evaluated with an in-depth neuropsychological battery focused on episodic memory and affective recognition/processing skills. FDG-PET data were analyzed at single-subject level according to a standardized and validated voxel-based Statistical Parametric Mapping (SPM) method. Results Patients showed severe episodic memory and fear recognition deficits at the neuropsychological assessment. No disorder of mentalizing processing was present. Variable patterns of increases and decreases of brain glucose metabolism emerged in the limbic structures, highlighting the pathology-driven selective vulnerability of this system. Additional involvement of cortical and subcortical regions, particularly in the sensorimotor system and basal ganglia, was found. Conclusions Episodic memory and fear recognition deficits characterize the cognitive profile of LE. Commonalities and differences may occur in the brain metabolic patterns. Single-subject voxel-based analysis of FDG-PET imaging could be useful in the early detection of the metabolic correlates of cognitive and non-cognitive deficits characterizing LE condition.

Original languageEnglish
Pages (from-to)81-87
Number of pages7
JournalBrain and Cognition
Volume108
DOIs
Publication statusPublished - Oct 1 2016

Keywords

  • Autoimmune limbic encephalitis
  • Episodic memory impairment
  • FDG-PET imaging
  • Fear recognition
  • VGKC-complex autoantibodies

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Experimental and Cognitive Psychology
  • Developmental and Educational Psychology
  • Arts and Humanities (miscellaneous)
  • Cognitive Neuroscience

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