title: More than memory impairment in voltage-gated potassium channel complex encephalopathy.
abstract: OBJECTIVE
  Autoimmune encephalopathies (AEs) are a heterogeneous group of neurological disorders that affect cognition. Although memory difficulties are commonly endorsed, few reports of AEs inclusively assess all cognitive domains in detail. Our aim was to perform an unbiased cognitive evaluation of AE patients with voltage-gated potassium channel complex antibodies (VGKCC -Abs) in order to delineate cognitive strengths and weaknesses.
  
  
  METHODS
  Serial VGKCC -Ab AE subjects (n = 12) were assessed with a comprehensive evaluation of memory, executive functions, visuospatial skills and language. Clinical magnetic resonance imaging (MRI) (n = 10/12) was evaluated. Five subjects had serial cognitive testing available, permitting descriptive analysis of change.
  
  
  RESULTS
  Subjects demonstrated mild to moderate impairment in memory (mean Z = -1.9) and executive functions (mean Z = -1.5), with variable impairments in language and sparing of visuospatial skills. MRI findings showed T2 hyperintensities in medial temporal lobe (10/10) and basal ganglia (2/10). Serial cognitive examination revealed heterogeneity in cognitive function; whereas most patients improved in one or more domains, residual impairments were observed in some patients.
  
  
  CONCLUSIONS
  This study augments previous neuropsychological analyses in VGKCC -Ab AE by identifying not only memory and executive function deficits but also language impairments, with preservation of visuospatial functioning. The study further highlights the importance of domain-specific testing to parse out the complex cognitive phenotypes of VGKCC -Ab AE.
authors: Department of Neurology, Memory and Aging Center, UCSF, San Francisco, CA, USA.
authors: B M
authors: BM
authors: Bettcher
authors: J M
authors: JM
authors: Gelfand
authors: S R
authors: SR
authors: Irani
authors: J
authors: J
authors: Neuhaus
authors: S
authors: S
authors: Forner
authors: C P
authors: CP
authors: Hess
authors: M D
authors: MD
authors: Geschwind
mesh_terms: D000328:Adult; D000368:Aged; D020274:Autoimmune Diseases of the Nervous System / Q000150:complications*; D003072:Cognition Disorders / Q000209:etiology*; D004660:Encephalitis / Q000150:complications*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D007806:Language Disorders / Q000209:etiology*; D008297:Male; D008569:Memory Disorders / Q000209:etiology*; D008875:Middle Aged; D024642:Potassium Channels, Voltage-Gated / Q000276:immunology*
chemical_list: D024642:Potassium Channels, Voltage-Gated
keywords: LGI1; autoimmune; cognitive