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Eur J Neurol ; 20(9): 1297-304, 2013 Sep.
Article de Anglais | MEDLINE | ID: mdl-23678940

RÉSUMÉ

BACKGROUND AND PURPOSE: Autoantibodies (abs) to glutamic acid decarboxylase (GAD) and to voltage-gated potassium channels (VGKC) induce distinct courses of limbic encephalitis, related to MRI findings, seizure outcome and cognition. METHODS: A detailed analysis of the cognitive course of the two forms is presented, spanning a median time interval of 28 months, including parameters of attention, learning and memory in 15 VGKC-ab-positive and 16 GAD-ab-positive patients. RESULTS: In both groups, the initially significantly impaired attention performance recovered to a putatively premorbid level. In VGKC patients the partially severely impaired learning and memory performance improved under treatment but remained subnormal at last follow-up. By contrast, GAD-ab-positive patients had initially less impaired learning and memory scores but did not show an improvement under treatment. CONCLUSIONS: The results provide evidence of distinct relations between inductive processes and cognitive outcome in VGKC-ab-positive and GAD-ab-positive subforms of limbic encephalitis, which possibly depend on differences in pathogenic molecular mechanisms and affected cerebral loci.


Sujet(s)
Autoanticorps/immunologie , Glutamate decarboxylase/immunologie , Encéphalite limbique/immunologie , Encéphalite limbique/psychologie , Canaux potassiques voltage-dépendants/immunologie , Adolescent , Adulte , Sujet âgé , Autoantigènes/immunologie , Encéphale/anatomopathologie , Enfant , Femelle , Humains , Immunoprécipitation , Encéphalite limbique/anatomopathologie , Imagerie par résonance magnétique , Mâle , Adulte d'âge moyen , Tests neuropsychologiques , Jeune adulte
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