A - 92 Neuropsychological Testing and Cognitive Outcomes in Autoimmune Encephalitis

Objective This review examines the use and outcomes of neuropsychological tests (NPT) in adults with autoimmune encephalitis (AE) with the objective of providing recommendations for NPT for clinical practice, observational research, and clinical trials. Data Selection PubMed search from inception to February 2023 yielded 8858 results which were screened for inclusion/exclusion criteria: ≥ one comprehensive NPT with comparison/normative reference value available of individual NPT scores, NPT reported within specific neuronal antibody group, English manuscript available, and sample size >5 (no case reports). 24 were included and involved anti-NMDA-R (k = 11), anti-LGI-1(k = 9), anti-GABAB-R (k = 2), anti-GAD-65 (k = 4), and anti-CASPR2 (k = 2). Data extracted included neuronal antibody, follow up time, sample size, and NPT. Data Synthesis List learning, figural memory, digit span, processing speed, response inhibition and semantic fluency tasks were most commonly administered. Impairments were most common in attention/working memory, processing speed, aspects of executive functions and episodic (60–100%). Differences emerged between antibody groups. For example, list learning impairments were common in anti-LGI-1(100%) and anti-NMDA-R (87.5%) but less common in other groups, while 67% of anti-LGI-1 studies showed impaired phonemic fluency compared to 0% of anti-NMDA-R studies, while rates of semantic fluency impairment were similar between those two groups (50–60%). Other group differences will be discussed. Conclusions We outline the most commonly administered and most impaired NPT in AE patients. Differences appeared in cognitive outcomes between antibody groups. Further use of NPT may better characterize these antibody-specific differences and support inclusion of standardized measures for clinical trial outcomes.