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Grant support

This study was supported in part by grants from Instituto Carlos III (CM14/00081, T.A.; CD14/00155, E.M.-H.) and Fondo de Investigaciones Sanitarias, FEDER (FIS 15/00377, F.G.; FIS 14/00203, J.D.), Madrid, Spain, NIH RO1NS077851 (J.D.), and Fundacio Cellex (J.D.).

Analysis of institutional authors

Mendes Braz, MarianaAuthorArino, HAuthorArmangue, TAuthorPetit-Pedrol, MAuthorSabater, LAuthorMartinez-Hernandez, EAuthorSaiz, AAuthorDalmau, JAuthorGraus, FCorresponding Author
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Article

Anti-LGI1-associated cognitive impairment: Presentation and long-term outcome

Publicated to:Neurology. 87 (8): 759-765 - 2016-08-23 87(8), DOI: 10.1212/WNL.0000000000003009

Authors: Arino, Helena; Armangue, Thais; Petit-Pedrol, Mar; Sabater, Lidia; Martinez-Hernandez, Eugenia; Hara, Makoto; Lancaster, Eric; Saiz, Albert; Dalmau, Josep; Graus, Francesc

Affiliations

Catalan Inst Res & Adv Studies ICREA, Barcelona, Spain - Author
Univ Barcelona, Hosp Clin, Neuroimmunol Program, August Pi Sunyer Biomed Res Inst IDIBAPS, E-08007 Barcelona, Spain.      Hospital Clinic de Barcelona    IDIBAPS    University of Barcelona - Author
Univ Barcelona, Hosp Clin, Neuroimmunol Program, August Pi Sunyer Biomed Res Inst IDIBAPS, E-08007 Barcelona, Spain      IDIBAPS    Hospital Clinic de Barcelona    University of Barcelona - Author
Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA      University of Pennsylvania       - Author

Abstract

We investigated a series of patients with LGI1 antibody (Ab)-related cognitive deterioration to determine the clinical presentation, long-term outcome, and LGI1 Ab evolution.We retrospectively analyzed the clinical information of 76 patients with LGI1 Ab-related cognitive deterioration. Presenting syndromes were classified as limbic encephalitis (LE), non-LE, or encephalopathy (normal MRI and no CSF pleocytosis). Frequency of relapses and clinical outcome were assessed in 48 patients with prolonged follow-up (median 39 months, range 18-200).Sixty-three patients (83%) developed LE, 3 (4%) non-LE, and 10 (13%) encephalopathy. All patients received steroids, IV immunoglobulins (Ig), or both. At 2 years, 17 (35%; 95% CI 21%-49%) fully recovered, 17 (35%) became functionally independent but not at baseline or were unable to return to work, 11 (23%) required assistance because of moderate or severe cognitive deficits, and 3 (6%) died. Predictors of bad outcome included no response to initial immunotherapy (odds ratio 23.0, 95% CI 2.4-215.6, p = 0.006) and clinical relapses (odds ratio 10.2, 95% CI 1.0-100.1, p = 0.047) that occurred in 13 patients (27%). In all patients, the LGI1 Abs were IgG4 and usually detectable in both serum and CSF (only CSF, 8%). Abs remained positive in serum of 4 of 16 patients with long-term follow-up; 3 of these 4 patients fully recovered and none showed class switch to IgG1.Up to 13% of patients with LGI1 Abs develop cognitive impairment without criteria of encephalitis. After immunotherapy, only 35% of patients return to their baseline cognitive function. Serum LGI1 Abs may remain detectable after full clinical recovery.© 2016 American Academy of Neurology.

Keywords
antibody-associated encephalopathyautoantibodiesautoimmune encephalitisdiagnosisimmunotherapyleucine-richlimbic encephalitisnmda receptor encephalitisrituximabAdultAgedAged, 80 and overAntibody-associated encephalopathyAutoantibodiesAutoimmune encephalitisBrain diseasesCognitive dysfunctionCreutzfeldt-jakob-diseaseDiagnosisDrug therapy, combinationFemaleFollow-up studiesHumansImmunoglobulin gImmunoglobulins, intravenousImmunologic factorsImmunotherapyIntracellular signaling peptides and proteinsLeucine-richLgi1 protein, humanLimbic encephalitisMaleMiddle agedNmda receptor encephalitisOutcome assessment, health careProteinsRituximabSteroids

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Neurology due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2016, it was in position 9/194, thus managing to position itself as a Q1 (Primer Cuartil), in the category Clinical Neurology.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 9.14. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Weighted Average of Normalized Impact by the Scopus agency: 35.5 (source consulted: FECYT Feb 2024)
  • Field Citation Ratio (FCR) from Dimensions: 71.01 (source consulted: Dimensions May 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-05-02, the following number of citations:

  • WoS: 232
  • Scopus: 284
  • Europe PMC: 138
  • OpenCitations: 273
Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-05-02:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 81.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 238 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 15.966.
  • The number of mentions on the social network Facebook: 1 (Altmetric).
  • The number of mentions on the social network X (formerly Twitter): 10 (Altmetric).
Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: United States of America.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (Ariño Rodriguez, Helena) and Last Author (Graus Ribas, Francesc).

the author responsible for correspondence tasks has been Graus Ribas, Francesc.