LAUSR

BACKGROUND Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is characterized by a range of cognitive impairments, especially in executive function. Our study aims to identify the abnormal regional homogeneity (ReHo) in anti-NMDAR encephalitis patients and its relationship with the executive function. METHODS Forty patients and forty-two healthy volunteers undertook the Attention Network Test (ATN) and resting-state fMRI scan. ReHo analysis was performed to investigate the neuronal activity synchronization in all subjects. Based on ReHo analysis, a multivariate pattern analysis (MVPA) was carried out to identify the brain regions that differed the most between the two groups. RESULTS Compared to controls, the patients had higher executive control (EC) scores (p < 0.05). The patients presented reduced ReHo values in the bilateral posterior cerebellar lobe, anterior cerebellar lobe, midbrain, bilateral caudate nucleus, right superior frontal gyrus, right middle temporal gyrus, bilateral inferior parietal lobule (IPL), and the left middle frontal gyrus. The ReHo values of bilateral IPL in patients were found to be negatively associated with the EC scores. The classification of patients and controls using MVPA had an accuracy of 76.83%,a sensitivity of 82.50%, a specificity of 71.43% and the area under the curve (AUC) was 0.83. CONCLUSIONS Our study provides evidence of abnormal cerebral function in anti-NMDAR encephalitis patients, which may contribute to unveil the neuropathological mechanisms of anti-NMDAR encephalitis and their influences on executive dysfunction. The MVPA classifier, based on ReHo, is helpful in identifying anti-NMDAR encephalitis patients from healthy controls.