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Objective <p>The aim of this study was to analyze the clinical characteristics of adult patients with anti-<i>N</i>-methyl-<span>d</span>-aspartate receptor (NMDAR) encephalitis combined with anti-myelin oligodendrocyte glycoprotein (MOG) antibodies.</p> Methods <p>This was a non-randomized controlled study. Clinical data were collected from 17 patients with anti-NMDAR encephalitis combined with anti-MOG antibodies admitted to Xuanwu Hospital, Capital Medical University, from January 2020 to August 2024. As controls, 20 patients with NMDAR(+)/MOG(−) and 27 patients with MOG(+)/NMDAR(−) were selected.</p> Results <p>The mean age of onset in the double-positive group was 33.47 ± 1.065&#xa0;years, with a male-to-female ratio of 14:3. Significant differences were observed between the NMDAR(+)/MOG(+) group and the NMDAR(+)/MOG(−) group in terms of headache, lumbar puncture pressure, and cerebrospinal fluid (CSF) leukocyte counts (<i>P</i> &lt; 0.05). Comparing the NMDAR(+)/MOG(+) group with the MOG(+)/NMDAR(−) group revealed significant differences in gender, headache, mental and behavioral abnormalities, limb twitching, loss of consciousness, cognitive impairment, speech impairment, visual impairment, limb numbness, cortical/sub-cortical white matter, brainstem lesions, OB type II, and CSF leukocyte counts (<i>P</i> &lt; 0.05). No statistically significant differences were found in the comparison of CSF and serum antibody titers among the three groups (<i>P</i> &gt; 0.05).</p> Conclusion <p>NMDAR and MOG antibodies can coexist in patients with autoimmune diseases, with a predominance of young male patients. The double-positive group exhibited more severe intracranial viral infections and a higher rate of intrathecal immunoglobulin synthesis in the central tissues. Compared to the double-positive group, NMDAR encephalitis alone presented with more similar clinical manifestations, while MOG-related disease demonstrated a higher likelihood of brainstem involvement.</p>

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Clinical characterization of diseases associated with anti-N-methyl-d-aspartate receptor encephalitis combined with anti-myelin oligodendrocyte glycoprotein antibodies in adults

  • 期刊论文

  • 发表日期：

    2025年3月12日

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  • Yingyue Ding,
  • Dalong Wu,
  • Hongshan Chu,
  • Yuqi Tang,
  • Liang Liu,
  • Zhandong Qiu,
  • Zheng Liu,
  • Huirong Yang,
  • Huiqing Dong,
  • Dawei Li

摘要

Objective

The aim of this study was to analyze the clinical characteristics of adult patients with anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis combined with anti-myelin oligodendrocyte glycoprotein (MOG) antibodies.

Methods

This was a non-randomized controlled study. Clinical data were collected from 17 patients with anti-NMDAR encephalitis combined with anti-MOG antibodies admitted to Xuanwu Hospital, Capital Medical University, from January 2020 to August 2024. As controls, 20 patients with NMDAR(+)/MOG(−) and 27 patients with MOG(+)/NMDAR(−) were selected.

Results

The mean age of onset in the double-positive group was 33.47 ± 1.065 years, with a male-to-female ratio of 14:3. Significant differences were observed between the NMDAR(+)/MOG(+) group and the NMDAR(+)/MOG(−) group in terms of headache, lumbar puncture pressure, and cerebrospinal fluid (CSF) leukocyte counts (P < 0.05). Comparing the NMDAR(+)/MOG(+) group with the MOG(+)/NMDAR(−) group revealed significant differences in gender, headache, mental and behavioral abnormalities, limb twitching, loss of consciousness, cognitive impairment, speech impairment, visual impairment, limb numbness, cortical/sub-cortical white matter, brainstem lesions, OB type II, and CSF leukocyte counts (P < 0.05). No statistically significant differences were found in the comparison of CSF and serum antibody titers among the three groups (P > 0.05).

Conclusion

NMDAR and MOG antibodies can coexist in patients with autoimmune diseases, with a predominance of young male patients. The double-positive group exhibited more severe intracranial viral infections and a higher rate of intrathecal immunoglobulin synthesis in the central tissues. Compared to the double-positive group, NMDAR encephalitis alone presented with more similar clinical manifestations, while MOG-related disease demonstrated a higher likelihood of brainstem involvement.