Cortical atrophy in early-stage patients with anti-NMDA receptor encephalitis: a machine-learning MRI study with various feature extraction

Author:

Shen Sisi1,Wei Ran2,Gao Yu2,Yang Xinyuan2,Zhang Guoning2,Yan Bo2,Xiao Zhuoling2,Li Jinmei1ORCID

Affiliation:

1. Department of Neurology, West China Hospital of Sichuan University , 37 GuoXue Alley, Chengdu 610041, China

2. School of Information and Communication Engineering, University of Electronic Science and Technology of China No.2006 , Xiyuan Ave, West Hi-Tech Zone, 611731| Chengdu, Sichuan, P.R. China

Abstract

Abstract Conventional brain magnetic resonance imaging (MRI) of anti-N-methyl-D-aspartate-receptor encephalitis (NMDARE) is non-specific, thus showing little differential diagnostic value, especially for MRI-negative patients. To characterize patterns of structural alterations and facilitate the diagnosis of MRI-negative NMDARE patients, we build two support vector machine models (NMDARE versus healthy controls [HC] model and NMDARE versus viral encephalitis [VE] model) based on radiomics features extracted from brain MRI. A total of 109 MRI-negative NMDARE patients in the acute phase, 108 HCs and 84 acute MRI-negative VE cases were included for training. Another 29 NMDARE patients, 28 HCs and 26 VE cases were included for validation. Eighty features discriminated NMDARE patients from HCs, with area under the receiver operating characteristic curve (AUC) of 0.963 in validation set. NMDARE patients presented with significantly lower thickness, area, and volume and higher mean curvature than HCs. Potential atrophy predominately presented in the frontal lobe (cumulative weight = 4.3725, contribution rate of 29.86%), and temporal lobe (cumulative weight = 2.573, contribution rate of 17.57%). The NMDARE versus VE model achieved certain diagnostic power, with AUC of 0.879 in validation set. Our research shows potential atrophy across the entire cerebral cortex in acute NMDARE patients, and MRI machine learning model has a potential to facilitate the diagnosis MRI-negative NMDARE.

Funder

Science and Technology Department of Sichuan Province

National Natural Science Foundation of China

Publisher

Oxford University Press (OUP)

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