Electroconvulsive therapy in N-methyl-d-aspartate receptor encephalitis: A retrospective cohort and scoping review of literature

J Neuroimmunol. 2024 Jul 15:392:578369. doi: 10.1016/j.jneuroim.2024.578369. Epub 2024 May 14.

Abstract

Neuropsychiatric symptoms in N-methyl-d-aspartate receptor encephalitis (NMDARE) have led some to pursue empiric trials of electroconvulsive therapy (ECT). A scoping review identified 39 patients diagnosed with NMDARE undergoing ECT. Separately, a retrospective cohort was reviewed to characterize 21 patients. Clinical improvement was attributed to ECT in 49% of patients in the scoping review and 19% of patients in the retrospective cohort; timing of immunotherapies was a confounding factor. Worsening of clinical course following ECT was reported in 28% of patients in the scoping review and 38% of patient in the retrospective review. There is currently insufficient data supporting a beneficial effect of ECT in NMDARE.

Keywords: Autoimmune encephalitis; Catatonia; Electroconvulsive therapy; N-methyl-d-aspartate receptor encephalitis; Neuropsychiatric symptoms.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis* / therapy
  • Cohort Studies
  • Electroconvulsive Therapy* / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult