Evidence map›Paper›PMID 39094249›Full record

ArticlePediatric neurology2024

Isolated Psychiatric Symptoms in Children With Anti-N-Methyl-d Aspartate Receptor Encephalitis.

Grace Gombolay, J Nicholas Brenton, Jennifer H Yang, Coral M Stredny, Ryan Kammeyer, Kristen S Fisher, Alexander J Sandweiss, Timothy A Erickson, Varun Kannan, Catherine Otten and 18 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

28 authors.

Grace GombolayDepartment of Pediatrics, Emory University SOM and Children's Healthcare of Atlanta, Atlanta, Georgia. Electronic address: ggombol@emory.edu.
J Nicholas BrentonDivision of Pediatric Neurology, Department of Neurology, University of Virginia Health System, Charlottesville, Virginia.
Jennifer H YangDepartment of Pediatrics, University of California San Diego and Rady Children's Hospital San Diego, San Diego, California.
Coral M StrednyDepartment of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
Ryan KammeyerDepartment of Pediatrics, University of Colorado SOM and Children's Hospital Colorado, Denver, Colorado.
Kristen S FisherDivision of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas.
Alexander J SandweissDivision of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas.
Timothy A EricksonSection of Pediatric Tropical Medicine, Department of Pediatrics, Center for Human Immunobiology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas; Laboratories for Emerging and Tropical Diseases, School of Public Health, Texas A&M University, College Station, Texas.
Varun KannanDepartment of Pediatrics, Emory University SOM and Children's Healthcare of Atlanta, Atlanta, Georgia; Division of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas.
Catherine OttenDepartment of Pediatrics, Seattle Children's/University of Washington, Seattle, Washington.
Claude SteriadeDepartment of Neurology, New York University SOM, New York, New York.
NgocHanh VuDepartment of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee.
Jonathan D SantoroDepartment of Neurology and Pediatrics, Children's Hospital Los Angeles; Keck School of Medicine, University of Southern California, Los Angeles, California.
Karla Robles-LopezDepartment of Pediatrics, University of Texas at Austin and Dell Medical School, Austin, Texas.
Robert GoodrichDepartment of Neurology, Atrium Wake Forest Baptist Health, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
Scott OtallahDepartment of Neurology, Atrium Wake Forest Baptist Health, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
Janetta ArellanoPediatric Neurology, Children's Hospital of Orange County, Orange, California.
Andrew ChristianaDepartment of Neurology, New York University SOM, New York, New York.
Morgan MorrisDepartment of Pediatrics, Emory University SOM and Children's Healthcare of Atlanta, Atlanta, Georgia.
Mark P GormanDepartment of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
Alexandra B KornbluhDepartment of Pediatrics, Children's National Hospital, George Washington University Medical School, Washington, District of Columbia.
Ilana KahnDepartment of Pediatrics, Children's National Hospital, George Washington University Medical School, Washington, District of Columbia.
Leigh SepetaDepartment of Pediatrics, Children's National Hospital, George Washington University Medical School, Washington, District of Columbia.
Yike JiangSection of Rheumatology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas.
Eyal MuscalDivision of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas; Section of Rheumatology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas.
Kristy O MurraySection of Pediatric Tropical Medicine, Department of Pediatrics, Center for Human Immunobiology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas.
Manikum MoodleyDepartment of Pediatrics, University of Texas at Austin and Dell Medical School, Austin, Texas.
Duriel HardyDepartment of Pediatrics, University of Texas at Austin and Dell Medical School, Austin, Texas.

Funding

Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE)UL1TR002378 · NCATS · EMORY UNIVERSITY · PI Andres J Garcia, Elizabeth O. Ofili · 2017 to 2026
$92.1M
Child Neurologist Career Development Program (CNCDP)K12NS098482 · NINDS · HUGO W. MOSER RES INST KENNEDY KRIEGER · PI SCHLAGGAR, BRADLEY L · 2016 to 2025
$26.2M
Institutional Career Development CoreKL2TR002381 · NCATS · EMORY UNIVERSITY · PI HENRY M BLUMBERG, Anandi Nayan Sheth · 2017 to 2026
$14.1M
Neuro HPA Project 1U54AG062334 · NIA · EMORY UNIVERSITY · PI Ighovwerha Ofotokun · 2018 to 2026
$12.2M
NCATS NIH HHS KL2 TR002381NCATS NIH HHS UL1 TR002378NIA NIH HHS U54 AG062334NINDS NIH HHS K12 NS098482
6 · The paper itself

Abstract

backgroundIsolated psychiatric symptoms can be the initial symptom of pediatric anti-N-methyl-d-aspartate (NMDA) receptor autoimmune encephalitis (pNMDARE). Here we report on the prevalence of isolated psychiatric symptoms in pNMDARE. We also assess whether initial neurodiagnostic tests (brain magnetic resonance imaging [MRI], electroencephalography [EEG], and/or cerebrospinal fluid [CSF] white blood cell count) are abnormal in children with isolated psychiatric symptoms and pNMDARE.

methodsThis multicenter retrospective cohort study from CONNECT (Conquering Neuroinflammation and Epilepsies Consortium) from 14 institutions included children under age 18 years who were diagnosed with pNMDARE. Descriptive statistics using means, medians, and comparisons for continuous versus discrete data was performed.

resultsOf 249 children included, 12 (5%) had only psychiatric symptoms without other typical clinical features of autoimmune encephalitis at presentation. All but one (11 of 12 = 92%) had at least one abnormal finding on initial ancillary testing: eight of 12 (67%) had an abnormal EEG, six of 12 (50%) had an abnormal MRI, and five of 12 (42%) demonstrated CSF pleocytosis. The single patient with a normal MRI, EEG, and CSF profile had low positive CSF NMDA antibody (titer of 1:1), and symptoms improved without immunotherapy.

conclusionsIsolated first-episode psychiatric symptoms in pNMDARE are uncommon, and the majority of children will exhibit additional neurodiagnostic abnormalities. Delaying immunotherapy in a child with isolated psychiatric symptoms and normal neurodiagnostic testing may be warranted while awaiting confirmatory antibody testing.

Indexed as

Anti-N-Methyl-D-Aspartate Receptor EncephalitisElectroencephalographyAdolescentChildChild, PreschoolFemaleHumansMagnetic Resonance ImagingMaleMental DisordersRetrospective StudiesAnti-NMDAREAnti-NMDA receptor encephalitisAnti-NMDAR encephalitisAutoimmune encephalitisEncephalitisPediatric autoimmune encephalitis

Identifiers

PMID39094249
PMCPMC11381152

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.