PMID- 30578370
OWN - NLM
STAT- MEDLINE
DCOM- 20191016
LR  - 20231109
IS  - 1526-632X (Electronic)
IS  - 0028-3878 (Print)
IS  - 0028-3878 (Linking)
VI  - 92
IP  - 3
DP  - 2019 Jan 15
TI  - A score that predicts 1-year functional status in patients with anti-NMDA 
      receptor encephalitis.
PG  - e244-e252
LID - 10.1212/WNL.0000000000006783 [doi]
AB  - OBJECTIVE: To construct a grading score that predicts neurologic function 1 year 
      after diagnosis of anti-NMDA receptor (NMDAR) encephalitis. METHODS: Three 
      hundred eighty-two patients with detailed information and functional status at 1 
      year were studied. Factors associated with poor status (defined as modified 
      Rankin Scale score >/=3) were identified and incorporated into a multivariate 
      logistic regression model. This model was used to develop a 5-point prediction 
      score, termed the anti-NMDAR Encephalitis One-Year Functional Status (NEOS) 
      score. RESULTS: Intensive care unit admission (p < 0.001), treatment delay >4 
      weeks (p = 0.012), lack of clinical improvement within 4 weeks (p < 0.001), 
      movement disorder (p = 0.001), central hypoventilation (p < 0.001), elevated CSF 
      white blood cell count (p < 0.001), elevated CSF protein level (p = 0.027), and 
      abnormal MRI (p = 0.002) were associated with 1-year functional status in 
      univariate analysis. Intensive care unit admission, treatment delay >4 weeks, 
      lack of clinical improvement within 4 weeks, abnormal MRI, and CSF white blood 
      cell count >20 cells/muL were independent predictors for outcome in multivariate 
      regression modeling. These 5 variables were assigned 1 point each to create the 
      NEOS score. NEOS score strongly associated with the probability of poor 
      functional status at 1 year (3% for 0 or 1 point to 69% for 4 or 5 points, p < 
      0.001). CONCLUSIONS: The NEOS score accurately predicts 1-year functional status 
      in patients with anti-NMDAR encephalitis. This score could help estimate the 
      clinical course following diagnosis and may aid in identifying patients who could 
      benefit from novel therapies.
CI  - Copyright (c) 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on 
      behalf of the American Academy of Neurology.
FAU - Balu, Ramani
AU  - Balu R
AD  - From the Department of Neurology (R.B., L.M., E.L., J.D.) and Division of 
      Neurocritical Care (R.B.), Perelman School of Medicine, University of 
      Pennsylvania, Philadelphia; Department of Neurology (F.G., J.D.), Hospital 
      Clinic, University of Barcelona/Institut d'Investigacions Biomediques August Pi i 
      Sunyer; Institucio Catalana de Recerca i Estudis Avancats (ICREA) (J.D.), 
      Barcelona, Spain; and Department of Neurology (M.J.T.), Erasmus University 
      Medical Center, Rotterdam, the Netherlands.
FAU - McCracken, Lindsey
AU  - McCracken L
AD  - From the Department of Neurology (R.B., L.M., E.L., J.D.) and Division of 
      Neurocritical Care (R.B.), Perelman School of Medicine, University of 
      Pennsylvania, Philadelphia; Department of Neurology (F.G., J.D.), Hospital 
      Clinic, University of Barcelona/Institut d'Investigacions Biomediques August Pi i 
      Sunyer; Institucio Catalana de Recerca i Estudis Avancats (ICREA) (J.D.), 
      Barcelona, Spain; and Department of Neurology (M.J.T.), Erasmus University 
      Medical Center, Rotterdam, the Netherlands.
FAU - Lancaster, Eric
AU  - Lancaster E
AD  - From the Department of Neurology (R.B., L.M., E.L., J.D.) and Division of 
      Neurocritical Care (R.B.), Perelman School of Medicine, University of 
      Pennsylvania, Philadelphia; Department of Neurology (F.G., J.D.), Hospital 
      Clinic, University of Barcelona/Institut d'Investigacions Biomediques August Pi i 
      Sunyer; Institucio Catalana de Recerca i Estudis Avancats (ICREA) (J.D.), 
      Barcelona, Spain; and Department of Neurology (M.J.T.), Erasmus University 
      Medical Center, Rotterdam, the Netherlands.
FAU - Graus, Francesc
AU  - Graus F
AD  - From the Department of Neurology (R.B., L.M., E.L., J.D.) and Division of 
      Neurocritical Care (R.B.), Perelman School of Medicine, University of 
      Pennsylvania, Philadelphia; Department of Neurology (F.G., J.D.), Hospital 
      Clinic, University of Barcelona/Institut d'Investigacions Biomediques August Pi i 
      Sunyer; Institucio Catalana de Recerca i Estudis Avancats (ICREA) (J.D.), 
      Barcelona, Spain; and Department of Neurology (M.J.T.), Erasmus University 
      Medical Center, Rotterdam, the Netherlands.
FAU - Dalmau, Josep
AU  - Dalmau J
AD  - From the Department of Neurology (R.B., L.M., E.L., J.D.) and Division of 
      Neurocritical Care (R.B.), Perelman School of Medicine, University of 
      Pennsylvania, Philadelphia; Department of Neurology (F.G., J.D.), Hospital 
      Clinic, University of Barcelona/Institut d'Investigacions Biomediques August Pi i 
      Sunyer; Institucio Catalana de Recerca i Estudis Avancats (ICREA) (J.D.), 
      Barcelona, Spain; and Department of Neurology (M.J.T.), Erasmus University 
      Medical Center, Rotterdam, the Netherlands. josep.dalmau@uphs.upenn.edu.
FAU - Titulaer, Maarten J
AU  - Titulaer MJ
AD  - From the Department of Neurology (R.B., L.M., E.L., J.D.) and Division of 
      Neurocritical Care (R.B.), Perelman School of Medicine, University of 
      Pennsylvania, Philadelphia; Department of Neurology (F.G., J.D.), Hospital 
      Clinic, University of Barcelona/Institut d'Investigacions Biomediques August Pi i 
      Sunyer; Institucio Catalana de Recerca i Estudis Avancats (ICREA) (J.D.), 
      Barcelona, Spain; and Department of Neurology (M.J.T.), Erasmus University 
      Medical Center, Rotterdam, the Netherlands.
LA  - eng
GR  - K08 NS075142/NS/NINDS NIH HHS/United States
GR  - R01 NS077851/NS/NINDS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20181221
PL  - United States
TA  - Neurology
JT  - Neurology
JID - 0401060
SB  - IM
CIN - Neurology. 2019 Jan 15;92(3):119-120. PMID: 30578369
CIN - J Neurol. 2019 May;266(5):1287-1289. PMID: 30877379
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-N-Methyl-D-Aspartate Receptor 
      Encephalitis/*diagnosis/genetics/*physiopathology
MH  - Child
MH  - Child, Preschool
MH  - Electroencephalography
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Infant
MH  - Logistic Models
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Movement Disorders/etiology
MH  - Neurologic Examination
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Young Adult
PMC - PMC6340387
EDAT- 2018/12/24 06:00
MHDA- 2019/10/17 06:00
PMCR- 2019/01/15
CRDT- 2018/12/23 06:00
PHST- 2018/05/22 00:00 [received]
PHST- 2018/09/05 00:00 [accepted]
PHST- 2018/12/24 06:00 [pubmed]
PHST- 2019/10/17 06:00 [medline]
PHST- 2018/12/23 06:00 [entrez]
PHST- 2019/01/15 00:00 [pmc-release]
AID - WNL.0000000000006783 [pii]
AID - NEUROLOGY2018906255 [pii]
AID - 10.1212/WNL.0000000000006783 [doi]
PST - ppublish
SO  - Neurology. 2019 Jan 15;92(3):e244-e252. doi: 10.1212/WNL.0000000000006783. Epub 
      2018 Dec 21.