Anti N-methyl-D-aspartate receptor encephalitis: a game-changer?

Corinne E. FischerKeenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada;Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada;Faculty of Medicine, Department of Psychiatry, University of Toronto, Toronto, ON, CanadaCorrespondence[email protected]

Angela C. GolasDepartment of Psychiatry, University of Toronto, Geriatric Psychiatry Subspecialty, Toronto, ON, Canada

Tom A. SchweizerKeenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada;Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada;Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada;Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, ON, Canada;Division of Neurosurgery, St. Michael’s Hospital, Toronto, ON, Canada

David G. MunozKeenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada;Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada;Division of Pathology, Department of Laboratory Medicine and Pathobiology, St. Michael’s Hospital, Toronto, ON, Canada

Zahinoor IsmailHotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada

Winnie QianKeenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada;Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada

David F. Tang-WaiDepartment of Medicine (Neurology and Geriatric Medicine), University of Toronto, Toronto, ON, Canada;UHN Memory Clinic, Toronto Western Hospital, Toronto, ON, Canada

Dalia L. RotsteinDepartment of Medicine (Neurology), University of Toronto, St. Michael’s Hospital, Toronto, ON, Canada

Gregory S. DayKnight Alzheimer Disease Research Center, Department of Neurology, Washington University in St. Louis, St. Louis, MO, Canada

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ABSTRACT

Introduction: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an inflammatory disorder of the brain that has garnered significant interest within the medical and lay communities. There is a need for formal guidelines to assist physicians in identifying patients who should undergo testing for NMDAR encephalitis, recognizing the high potential for this potentially treatable disease to mimic more common disorders, and consequently remain undiagnosed.

Areas covered: This review highlights the impact of the discovery of NMDAR encephalitis on the fields of neurology and psychiatry, and discusses the steps that are necessary to improve recognition and treatment of NMDAR encephalitis.

Expert commentary: While much progress has been made in our understanding of NMDAR encephalitis, much work remains to be done to delineate the underlying disease mechanisms and their relevance to brain function.

KEYWORDS:

Declaration of interests

G Day receives research support via the American Academy of Neurology/American Brain Foundation Clinical Research Training Fellowship. He is involved in research supported by an in-kind gift of radiopharmaceuticals from Avid Radiopharmaceuticals, and is currently participating in clinical trials of anti-dementia drugs sponsored by the A4 (The Anti-Amyloid Treatment in Asymptomatic Alzheimer’s Disease) trial. He holds stocks (>$10,000) in ANI Pharmaceuticals (a generic pharmaceutical company). He is also the Clinical Director of the Anti-NMDA Receptor Encephalitis Foundation, Inc (Canada). The Foundation is supported by private donation; G Day is not directly compensated for his work with the Foundation. D Rotstein received research support from the MS Society of Canada and Biogen Idec and has served as a consultant for Novartis, EMD Serono, and Sanofi. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

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Anti N-methyl-D-aspartate receptor encephalitis: a game-changer?

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Anti N-methyl-D-aspartate receptor encephalitis: a game-changer?

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