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@ARTICLE{vonZedtwitz:281736,
author = {von Zedtwitz, Katharina and Tebartz van Elst, Ludger and
Matteit, Isabelle and Schlump, Andrea and Lange, Thomas and
Runge, Kimon and Weiser, Judith and Nickel, Kathrin and
Domschke, Katharina and Prüss, Harald and Rau, Alexander
and Reisert, Marco and Maier, Simon J. and Feige, Bernd and
Endres, Dominique},
title = {{A}lterations in functional connectivity analyzed using
{MREG} in patients with suspected autoimmune psychosis
spectrum syndromes},
journal = {Brain, behavior, $\&$ immunity - health},
volume = {49},
issn = {2666-3546},
address = {[Amsterdam]},
publisher = {Elsevier B.V.},
reportid = {DZNE-2025-01169},
pages = {101111},
year = {2025},
abstract = {IntroductionIn NMDA-R encephalitis, which is typically
accompanied by psychotic symptoms, conventional magnetic
resonance imaging (MRI) is often normal, despite widespread
alterations in functional connectivity. This is the first
functional connectivity study in psychiatric patients with
suspected autoimmune psychosis (AP) spectrum
syndromes.MethodsTwenty-eight patients with suspected AP
spectrum syndromes who were selected according to the
concept of autoimmune psychiatric syndromes (APS) and 28
matched healthy controls (HCs) were examined with ultrafast
functional MRI using magnetic resonance encephalography
(MREG). Patients were positive for either well-characterized
or novel central nervous system antibodies or
well-characterized systemic antibodies with autoimmune brain
involvement. MREG data were processed using “Analysis of
Functional NeuroImages” (AFNI) with the “Functional And
Tractographic Connectivity Analysis AFNI toolbox” to
analyze connectivity across 170 regions, yielding an
analysis of 5995 evaluable connectivities.ResultsAfter
correction for multiple testing, functional connectivity
between the left middle cingulate/paracingulate gyri and the
right insula (padj = 0.025) was significantly reduced in the
patient group compared to HCs. Exploratory analyses revealed
widespread global functional connectivity alterations in 226
of all connections (corresponding to 3.8 $\%).$ Notably, of
these altered connections, 99 $\%$ showed reduced
connectivity, while 1 $\%$ showed hyperconnectivity. The
medial pulvinar of the left thalamus emerged as the most
disconnected hub with altered connectivity to 33 other
regions. Overall, 46 $\%$ of all analyzed regions exhibited
at least one altered functional connectivity, with 19 $\%$
of hubs located in the cerebellum, 11 $\%$ in the frontal
brain, and 9 $\%$ in the thalami. After correction for
multiple comparisons, increased connectivity between the
left insula and the left superior temporal gyrus correlated
with the Beck Depression Inventory scores (padj =
0.043).DiscussionPatients with suspected AP spectrum
syndromes exhibit altered insular functional connectivity
associated with the severity of depressive symptoms. Broader
changes identified via hypothesis-generating analyses
highlighted major hubs in the cerebellum, frontal brain, and
thalamus. These findings suggest that functional MRI may
serve as an additional tool for detecting patients with
AP/APS. Future studies in more homogeneous
autoimmune-mediated patient groups may help delineate
specific connectivity signatures in functional networks.},
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},
doi = {10.1016/j.bbih.2025.101111},
url = {https://pub.dzne.de/record/281736},
}