Cardiac sympathetic dysfunction in anti-NMDA receptor encephalitis.
Patients with anti-NMDA receptor (anti-NMDAR) encephalitis frequently suffer from autonomic dysfunctions, which can cause substantial morbidity. This study assessed cardiac autonomic functions in patients with anti-NMDAR encephalitis using heart rate variability (HRV) analysis. This was a retrospective single-center case-control study. Eleven patients with anti-NMDAR encephalitis and 15 age- and sex-matched controls were included in this study. To ensure that autonomic dysfunction does not occur in any encephalitis, we additionally analyzed HRV of 9 patients with herpes encephalitis (HSE) and compared with that of NMDAR encephalitis patients and controls. Five minute resting stationary electrocardiogram was collected from each subject, and HRV was analyzed. Total power and low frequency (LF) power were lower in anti-NMDAR encephalitis patients than those in controls (p=0.005, 0.001 respectively), indicating cardiac autonomic dysfunction especially in sympathetic system. Patients with HSE showed no significant difference in HRV parameters compared with that of controls. Cardiac autonomic dysfunction was associated with 3 month functional outcome in anti-NMDAR encephalitis patients.
Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea.
Jung-Ick
JI
Byun
Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea.
Soon-Tae
ST
Lee
Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea.
Jangsup
J
Moon
Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea.
Keun-Hwa
KH
Jung
Department of Neurology, Cha University, CHA Bundang Medical Center, Seongnam, South Korea.
Jung-Won
JW
Shin
Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea.
Jun-Sang
JS
Sunwoo
Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea.
Jung-Ah
JA
Lim
Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea.
Yong-Won
YW
Shin
Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea.
Tae-Joon
TJ
Kim
Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea.
Keon-Joo
KJ
Lee
Department of Neurology, Seoul Paik Hospital, Inje University College of Medicine, Seoul, South Korea.
Kyung-Il
KI
Park
Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea.
Ki-Young
KY
Jung
Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea.
Sang Kun
SK
Lee
Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: stemcell.snu@gmail.com.
Kon
K
Chu
D000293:Adolescent; D000328:Adult; D000368:Aged; D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000503:physiopathology*; D016022:Case-Control Studies; D004562:Electrocardiography; D020803:Encephalitis, Herpes Simplex / Q000503:physiopathology; D005260:Female; D006321:Heart / Q000503:physiopathology; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012146:Rest; D012189:Retrospective Studies; D013564:Sympathetic Nervous System / Q000503:physiopathology; D055815:Young Adult
Anti-NMDAR encephalitis; Autonomic function; Heart rate variability; Herpes encephalitis; Outcome