Observational studyFrontiers in immunology2026
Predictive value of persistent cerebrospinal fluid antibodies at 12 months for long-term clinical outcomes in pediatric anti-NMDAR encephalitis: a retrospective cohort study.
Observational study in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Background and objective: Persistent cerebrospinal fluid (CSF) antibodies against the N-methyl-D-aspartate receptor (NMDAR) are common in children recovering from anti-NMDAR encephalitis, but their association with long-term clinical outcomes remains unclear. This study aimed to assess whether persistent CSF NMDAR antibodies at 12 months after diagnosis predict long-term clinical outcomes. Methods: In this retrospective observational cohort study, we included patients diagnosed with pediatric anti-NMDAR encephalitis between November 2012 and January 2026. Participants were stratified into two groups according to their CSF NMDAR antibody status at the 12-month follow-up. Clinical characteristics were compared between the groups, and long-term seizure-free rates were assessed using Kaplan-Meier survival analysis. Results: Among 162 initially identified patients, 41 (25.3%) met the inclusion criteria (mean age 8.7 ± 4.2 years; 78.0% female). At 12 months, CSF NMDAR antibodies remained detectable in 68.3% (28/41) of patients. Although the antibody-persistent group showed a trend toward a higher relapse rate than the antibody-negative group (42.9% vs. 0%), this difference did not reach statistical significance ( Conclusion: In pediatric anti-NMDAR encephalitis, persistent CSF NMDAR antibodies at 12 months serve as a marker of incomplete remission and are associated with a trend toward a higher relapse rate and a significantly greater need for intensified immunotherapy, and may help identify patients who would benefit from more intensive immunomodulatory therapy.
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