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@ARTICLE{Heine:273975,
author = {Heine, Josephine and Boeken, Ole Jonas and Rekers, Sophia
and Wurdack, Katharina and Prüss, Harald and Finke,
Carsten},
title = {{P}atient-{R}eported {O}utcome {M}easures in {NMDA}
{R}eceptor {E}ncephalitis.},
journal = {Neurology: Neuroimmunology $\&$ Neuroinflammation ;
official journal of the American Academy of Neurology},
volume = {12},
number = {1},
issn = {2332-7812},
address = {Philadelphia, Pa.},
publisher = {Wolters Kluwer},
reportid = {DZNE-2024-01424},
pages = {e200343},
year = {2025},
abstract = {The characteristics of persistent long-term symptoms and
their contribution to subjective quality of life remain
unclear in patients with NMDAR encephalitis. In this study,
we aimed to evaluate postacute neuropsychiatric symptoms,
subjective cognitive complaints, and disease coping
mechanisms and identify predictors of health-related quality
of life (HRQoL) after N-methyl-D-aspartate receptor (NMDAR)
encephalitis.This cross-sectional observational study
investigated patients with NMDAR encephalitis in the
postacute phase. Psychometric scales included assessment of
neuropsychiatric symptoms (i.e., fatigue, sleep, anxiety,
and depressive symptoms), HRQoL, everyday independence,
metamemory (i.e., self-rated ability, satisfaction, and use
of strategies), and coping strategies (i.e., self-efficacy,
disease-related coping, and stress management).A total of 50
patients (mean age 26.0 ± 10.1 years, $86\%$ female)
participated at a median of 4.15 (range 0.3-30.3) years
after symptom onset. Patients reported significantly
increased levels of anxiety (Beck Anxiety Inventory: 10.5 ±
7.7 [mean ± SD], $95\%$ CI [8.32-12.71], p < 0.001) and
depressive (Beck Depression Inventory-II: 11.4 ± 7.7
[9.22-13.62], p = 0.001) symptoms compared with the
normative population. Both sleep problems (Pittsburgh Sleep
Quality Index: 5.8 ± 3.0 [4.98-6.66], p < 0.001) and motor
and cognitive fatigue (Fatigue Scale for Motor and Cognitive
Function: 50.5 ± 23.1 [42.5-58.4], p < 0.001) were
significantly more prevalent. Moreover, lower self-rated
memory ability (Multifactorial Memory Questionnaire score:
54.6 ± 8.5 [52.1-57.1], p = 0.004) was associated with
greater reliance on compensatory strategies and memory aids
(r = -0.41, p = 0.004). Patients used significantly fewer
cognitive coping strategies, such as relativization (11.7 ±
4.7 [10.3-13.1], p = 0.001), while depressive coping
prevailed (49.1 ± 15.5 [44.5-53.8], p < 0.001). It is
important to note that HRQoL was predicted by self-reported
affective symptoms, self-efficacy, and coping behaviors in
multivariable regression analyses, but not by acute disease
severity or postacute physical disability.Our findings show
that persistent neuropsychiatric and subjective cognitive
concerns explain a large part of the reduced quality of life
in patients with NMDAR encephalitis. These findings have
important implications for a patient-centered postacute care
and the role of disease coping strategies in the
neurorehabilitation of autoimmune encephalitis.},
keywords = {Humans / Female / Male / Anti-N-Methyl-D-Aspartate Receptor
Encephalitis: complications / Anti-N-Methyl-D-Aspartate
Receptor Encephalitis: psychology /
Anti-N-Methyl-D-Aspartate Receptor Encephalitis:
physiopathology / Adult / Cross-Sectional Studies / Patient
Reported Outcome Measures / Quality of Life / Young Adult /
Adaptation, Psychological: physiology / Adolescent / Middle
Aged},
cin = {AG Prüß},
ddc = {610},
cid = {I:(DE-2719)1810003},
pnm = {353 - Clinical and Health Care Research (POF4-353)},
pid = {G:(DE-HGF)POF4-353},
typ = {PUB:(DE-HGF)16},
pmc = {pmc:PMC11649178},
pubmed = {pmid:39671210},
doi = {10.1212/NXI.0000000000200343},
url = {https://pub.dzne.de/record/273975},
}