ArticleNeurology(R) neuroimmunology & neuroinflammation2026
Clinical Features and Biomarkers Associated With Intensive Care-Dependent Refractory NMDAR Encephalitis: A Retrospective Cohort Study.
Article in Neurology(R) neuroimmunology & neuroinflammation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Daratumumab Treatment in Severe Anti-NMDAR Encephalitis: Two Case Reports and Literature Review.Neurology(R) neuroimmunology & neuroinflammation · 2026Review
- Anti-NMDA receptor encephalitis outcomes in a population-based cohort.Journal of neurology · 2026Article
- Phenotypic Diversity and Outcomes in Pediatric NMDA Receptor Encephalitis: A 15-Year Retrospective Study from the Largest Children's Hospital in the United States.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
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Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesA subset of patients with NMDAR encephalitis is resistant to first-line and second-line immunotherapy and requires prolonged intensive care. The clinical definition of refractory, intensive care-dependent NMDARE (RI-NMDARE) is lacking, and its frequency, risk factors, and outcomes are unknown. The aim of this study was to define RI-NMDARE and compare its clinical and biomarker characteristics with those of severe NMDARE.
methodsThis was a retrospective cohort study including patients with nonherpetic NMDARE admitted to intensive care units (ICUs) and diagnosed at the French National Reference Center, from 2005 to 2023. Favorable outcome was defined as a modified Rankin Scale (mRS) score < 2 at 24 months from onset.
resultsThe study included 216 ICU-admitted patients with NMDARE (81% female, median age 21 years). Nearly 90% of patients were discharged from ICU within 3 months after initiation of second-line therapy; the remainder were defined as patients with RI-NMDARE (26/216 patients, 12%; 92% female; median age, 24 years-none younger than 15 years; median ICU stay, 5.7 months). Compared with the rest of the cohort, patients with RI-NMDARE were more frequently of non-White ethnicity (14/25, 56%, vs 55/156, 35%; DISCUSSION: RI-NMDARE represents a distinct, high-risk subgroup with a severe clinical profile marked by rapid disease progression; the triad of seizures, movement disorders, and dysautonomia; and elevated biomarkers. RI-NMDARE is associated with poorer outcomes, underscoring the need for early recognition and tailored therapeutic strategies.
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