Imaging Features and Prognosis of Anti‑Sez6l2 Encephalitis: A Longitudinal Cohort Study and Literature Review.
Siyu Dong, Siqi Tu, Sheng Chen et al.
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In 30 seconds
This longitudinal cohort study and systematic review examined clinical features, multimodal imaging, and treatment response in anti-Sez6l2 encephalitis. The cohort comprised five antibody-positive patients aged 15–72 years; the review included 18 cases. All five cohort patients had ataxia and cognitive deficits. MRI showed cerebellar atrophy in three, while 18F-DPA714 PET/MRI detected cerebellar microglial activation in four and bilateral mesial temporal activation in one. Across the review, ataxia was universal (100%), cognitive impairment occurred in 72%, and median residual disability was mRS 4.
Key findings
- In the five-patient cohort, all had ataxia and cognitive deficits; MRI showed cerebellar atrophy in three.
- 18F-DPA714 PET/MRI detected cerebellar microglial activation in four patients and bilateral mesial temporal activation in one.
- In Case 1, clinical improvement paralleled a 7%-8% reduction in cerebellar tracer uptake.
- The systematic review of 18 cases found ataxia in 100%, cognitive impairment in 72%, and median residual disability of mRS 4.
Why it matters
The findings illustrate that structural MRI may not capture all imaging evidence of neuroinflammation in this rare encephalitis, while PET/MRI findings in this small cohort corresponded to clinical phenotypes and tracked change in one case. The review also indicates that substantial disability may persist, underscoring the clinical importance of recognizing both cognitive and motor involvement.
What to keep in mind
The longitudinal cohort included only five patients, and the treatment observations are uncontrolled; the abstract does not establish comparative efficacy of immunotherapy regimens.