Anti-LGI-1 (Anti-leucine-rich glioma-inactivated 1) encephalitis is one of the most common types of autoimmune encephalitis, and psychiatric symptoms are among its important clinical manifestations. Relevant clinical studies are still in the minority. This study aimed to investigate the clinical features and disease outcomes of adult anti-LGI1 encephalitis patients with psychiatric symptoms. This study retrospectively analyzed 68 patients with anti-LGI-1 encephalitis from January 2016 to August 2024, grouped by the presence of psychiatric symptoms. Comparisons included clinical features, laboratory findings, MRI features, treatment, and prognosis. This study included 50 patients completing the 12-month follow-up. 64% of the patients developed psychiatric symptoms during the disease, with personality changes, hallucinations, and mood disorder being the most common manifestations. Patients with psychiatric symptoms had a higher rate of cerebrospinal fluid antibodies (p < 0.001), more severe blood-brain barrier damage indicated (p = 0.009), greater likelihood of cognitive decline (p = 0.016), electrolyte imbalances like hyponatremia (p = 0.02), worse mRS and CASE scores at onset (p < 0.001), higher rates of delayed immunotherapy initiation (p = 0.003) and second-line therapy (p = 0.042), as well as poorer prognosis after one year with more relapses (p = 0.016). Patients with anti-LGI-1 encephalitis show a variety of psychiatric symptoms, often portending a more severe disease phenotype. This suggests that psychiatric symptoms may indicate the disease’s severity and prognosis early on. Not applicable.
Yi et al. (Thu,) studied this question.