PURPOSE This study aimed to investigate brain white matter (WM) changes and their relationship to cognition in patients with anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis. Multivariate pattern analysis (MVPA) was used to explore brain regions that play an important role in classification. METHODS Fifteen patients and fifteen controls underwent Montreal Cognitive Assessment (MoCA) and diffusion tensor imaging. Based on fractional anisotropy (FA) and mean diffusivity (MD) for MVPA classification, the weights of each brain region were calculated. RESULTS Compared with the controls, the patients showed an FA reduction in right middle temporal gyrus, left middle cerebellar peduncle, right praecuneus, and an MD increase in left medial temporal gyrus and left frontal lobe. The MoCA score for patients was lower than controls, especially in executive function, fluency, delayed recall and visual perception items. The FA value of right praecuneus was positively correlated with total MoCA score and fluency score. The MD of left frontal lobe was negatively correlated with total MoCA score, and MD of the left medial temporal gyrus was positively correlated with delayed recall. The accuracy, sensitivity and specificity of classification based on FA were 70%, 60% and 80%, respectively. Based on MD, they were each 80%. The brain regions with large weights from FA and MD overlap in temporal lobe, cerebellum and hippocampus. CONCLUSIONS These results suggest that WM changes are associated with cognitive deficits. MVPA based on FA and MD has good classification ability. Our study may provide new insights into the pathophysiological mechanisms of residual cognitive deficits.

中文翻译：

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抗NMDA受体脑炎的扩散张量成像研究基于体素的分析和多元模式分析。

目的本研究旨在调查抗N-甲基-D-天冬氨酸（抗NMDA）受体脑炎患者的脑白质（WM）变化及其与认知的关系。多变量模式分析（MVPA）用于探索在分类中起重要作用的大脑区域。方法对15例患者和15例对照进行了蒙特利尔认知评估（MoCA）和弥散张量成像。基于MVPA分类的分数各向异性（FA）和平均扩散率（MD），计算每个大脑区域的权重。结果与对照组相比，患者右中颞回，左中小脑梗，右胸骨的FA减少，左内侧颞回和左额叶的MD增加。患者的MoCA得分低于对照组，特别是在执行功能，流利性，延迟召回和视觉感知项目方面。右胰腺的FA值与MoCA总分和流利度正相关。左额叶的MD与总MoCA评分呈负相关，而左内侧颞回的MD与延迟回想呈正相关。基于FA的分类的准确性，敏感性和特异性分别为70％，60％和80％。根据MD，它们分别为80％。来自FA和MD的权重较大的大脑区域在颞叶，小脑和海马区重叠。结论这些结果表明，WM的变化与认知缺陷有关。基于FA和MD的MVPA具有良好的分类能力。我们的研究可能会为残留的认知缺陷的病理生理机制提供新的见解。