Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2024 Nov;45(11):5429-5439.
doi: 10.1007/s10072-024-07652-z. Epub 2024 Jun 24.

Distinctive sleep complaints and polysomnographic findings in antibody subgroups of autoimmune limbic encephalitis

Cem İsmail Küçükali  1 , Vuslat Yılmaz  1 , Derya Karadeniz  2 , Utku Oğan Akyıldız  3 , Demet İlhan Algın  4 , Ayşegül Şeyma Sarıtaş  5 , Ayşın Kısabay Ak  5 , Aylin Bican Demir  6 , Hikmet Yılmaz  5 , Füsun Mayda Domaç  7 , Ayşe Deniz Elmalı  8 , Ülkü Dübüş Hoş  8 , R Gökçen Gözübatık-Çelik  9 , Vasfiye Kabeloğlu  9 , Bengisu Bilgin  10 , Deniz Tuncel Berktaş  11 , Bengi Gül Türk  2 , Şakir Delil  2 , Cengiz Dilber  10 , Sedef Terzioğlu Öztürk  10 , S Naz Yeni  2 , Çiğdem Özkara  2 , Murat Aksu  12 , Erdem Tüzün #  1 , Gülçin Benbir Şenel #  13
Affiliations
Multicenter Study

Distinctive sleep complaints and polysomnographic findings in antibody subgroups of autoimmune limbic encephalitis

Cem İsmail Küçükali et al. Neurol Sci. 2024 Nov.

Abstract

Introduction: Sleep disturbances are being increasingly recognized in association with autoimmune encephalitis (AIE). We investigated the prevalence of sleep-related symptoms and polysomnographic features of patients with AIE and the long-term outcomes in these patients in a multi-center, prospective study from Turkey.

Methods: We prospectively evaluated patients with definite AIE in a common database including demographics, AIE-related and sleep-related symptomatology. Maximum and latest modified Rankin scores (mRS) and Liverpool Outcome Score (LOS) were noted.

Results: Of 142 patients, 87 patients (61.3%) fulfilled the criteria for definite AIE (mean age, 46.8+18.8 years; 51.7% women; mean disease duration, 21.0+38.4 months). 78.9% of patients had at least one or more new onset or worsened sleep-related symptomatology: insomnia (55.3%), excessive daytime sleepiness (EDS, 28.0%), sleep apnea (18.7%), REM sleep behavior disorder (RBD, 17.3%), restless legs syndrome (10.7%) and oneiric stupor (9.3%). Sleep efficiency, N3 and REM sleep were decreased and N1 sleep was increased in patients with Ab[+] AIE. LOS points were highest in those with insomnia and sleep apnea, and lowest in those with EDS, RBD and oneiric stupor. RBD and sleep apnea were more common in anti-LG1 Ab[+] group than anti-NMDAR Ab[+] group. Index of periodic leg movements was highest in anti-LG1 Ab[+] group. Patients with EDS and oneiric stupor had more common memory problems. Maximum and latest mRS scores were positively correlated with EDS and oneiric stupor. EDS, RBD and oneiric stupor were negatively correlated with LOS points.

Conclusion: Our study emphasizes the presence and importance of early diagnosis of sleep disturbances in AIE in regard to their deteriorative influences on disease prognosis.

Keywords: Autoimmune encephalitis; Polysomnography; Prognosis; Sleep disturbances.

PubMed Disclaimer

Conflict of interest statement

None

Figures

Fig. 1
Fig. 1
The frequency (%) of AIE-related symptoms between Ab[-] and Ab[+] groups. *p values: encephalopathy, p=0.270; memory problems, p=0.593; psychiatric problems, p=0.502; catatonia/mutism, p=0.567, epileptic seizures, p=0.614; dystonia or other movement disorders, p=0.163; autonomic disturbances, p=0.400; endocrine disturbances, p=0.366
Fig. 2
Fig. 2
The frequency (%) of sleep-related symptoms between Ab[-] and Ab[+] groups. *p values: insomnia, p=0.395; excessive daytime sleepiness, p=0.350; sleep apnea, p=0.335; REM sleep behavior disorder, p=0.611; restless legs syndrome, p=0.667; oneiric stupor, p=0.728
Fig. 3
Fig. 3
The frequency (%) of AIE-related symptoms among AIE patients with different Ab subgroups. *p values: encephalopathy, p=0.298; memory problems, p=0.685; psychiatric problems, p=0.685; catatonia/mutism, p=0.640, epileptic seizures, p=0.497; dystonia or other movement disorders, p=0.001; autonomic disturbances, p=0.028; endocrine disturbances, p=0.038
Fig. 4
Fig. 4
The frequency (%) of sleep-related symptoms among AIE patients with different Ab subgroups. *p values: insomnia, p=0.167; excessive daytime sleepiness, p=0.739; sleep apnea, p=0.067; REM sleep behavior disorder, p=0.074; restless legs syndrome, p=0.464; oneiric stupor, p=0.979
See this image and copyright information in PMC

References

    1. Pérez-Carbonell L, Iranzo A (2023) Sleep disturbances in autoimmune neurological diseases. Curr Neurol Neurosci Rep 23(10):617–625. 10.1007/s11910-023-01294-y - PubMed
    1. Cornelius JR, Pittock SJ, McKeon A, Lennon VA, Aston PA, Josephs KA, Tippmann-Peikert M, Silber MH (2011) Sleep manifestations of voltage-gated potassium channel complex autoimmunity. Arch Neurol 68:733–738. 10.1001/archneurol.2011.106 - PubMed
    1. Blattner MS, de Bruin GS, Bucelli RC, Day GS (2019) Sleep disturbances are common in patients with autoimmune encephalitis. J Neurol 266(4):1007–1015. 10.1007/s00415-019-09230-2 - PMC - PubMed
    1. Gaig C, Graus F, Compta Y, Hogl B, Bataller L, Bruggemann N, Giordana C, Heidbreder A, Kotschet K, Lewerenz J, Macher S, Marti MJ, Montojo T, Perez-Perez J, Puertas I, Seitz C, Simabukuro M, Tellez N, Wandinger KP et al (2017) Clinical manifestations of the anti-IgLON5 disease. Neurology 88:1736–1743. 10.1212/WNL.0000000000003887 - PMC - PubMed
    1. Erkent I, Elibol B, Saka E, Saygi S, Tezer I (2023) Sleep disorders and polysomnography findings in patients with autoimmune encephalitis. Neurol Sci 44(4):1351–1360. 10.1007/s10072-022-06513-x - PubMed

Publication types

Supplementary concepts

LinkOut - more resources