Brain rhythmic abnormalities in convalescent patients with anti-NMDA receptor encephalitis: a resting-state EEG study

Objective

Anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDARE) is autoimmune encephalitis with a characteristic neuropsychiatric syndrome and persistent cognition deficits even after clinical remission. The objective of this study was to uncover the potential noninvasive and quantified biomarkers related to residual brain distortions in convalescent anti-NMDARE patients.

Methods

Based on resting-state electroencephalograms (EEG), both power spectral density (PSD) and brain network analysis were performed to disclose the persistent distortions of brain rhythms in these patients. Potential biomarkers were then established to distinguish convalescent patients from healthy controls.

Results

Oppositely configured spatial patterns in PSD and network architecture within specific rhythms were identified, as the hyperactivated PSD spanning the middle and posterior regions obstructs the inter-regional information interactions in patients and thereby leads to attenuated frontoparietal and frontotemporal connectivity. Additionally, the EEG indexes within delta and theta rhythms were further clarified to be objective biomarkers that facilitated the noninvasive recognition of convalescent anti-NMDARE patients from healthy populations.

Conclusion

Current findings contributed to understanding the persistent and residual pathological states in convalescent anti-NMDARE patients, as well as informing clinical decisions of prognosis evaluation.

Brain variability in dynamic resting-state networks identified by fuzzy entropy: a scalp EEG study

Objective.Exploring the temporal variability in spatial topology during the resting state attracts growing interest and becomes increasingly useful to tackle the cognitive process of brain networks. In particular, the temporal brain dynamics during the resting state may be delineated and quantified aligning with cognitive performance, but few studies investigated the temporal variability in the electroencephalogram (EEG) network as well as its relationship with cognitive performance.Approach.In this study, we proposed an EEG-based protocol to measure the nonlinear complexity of the dynamic resting-state network by applying the fuzzy entropy. To further validate its applicability, the fuzzy entropy was applied into simulated and two independent datasets (i.e. decision-making and P300).Main results.The simulation study first proved that compared to the existing methods, this approach could not only exactly capture the pattern dynamics in time series but also overcame the magnitude effect of time series. Concerning the two EEG datasets, the flexible and robust network architectures of the brain cortex at rest were identified and distributed at the bilateral temporal lobe and frontal/occipital lobe, respectively, whose variability metrics were found to accurately classify different groups. Moreover, the temporal variability of resting-state network property was also either positively or negatively related to individual cognitive performance.Significance.This outcome suggested the potential of fuzzy entropy for evaluating the temporal variability of the dynamic resting-state brain networks, and the fuzzy entropy is also helpful for uncovering the fluctuating network variability that accounts for the individual decision differences.