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oai:figshare.com:article/34038210 2026-10-01T04:31:58Z category_696 portal_316 item_type_1 month_year_10_2026

Supplementary file 1_Predictive value of persistent cerebrospinal fluid antibodies at 12 months for long-term clinical outcomes in pediatric anti-NMDAR encephalitis: a retrospective cohort study.jpg Hua Yang (120668) Ruling Zhang (14050591) Jie Yang (121778) Jingui Zhao (25151835) Xiaoling Zhong (181270) Rong Luo (187167) Genetic Immunology anti-N-methyl-D-aspartate receptor encephalitis cerebrospinal fluid antibodies children clinical outcomes prognosis Background and objective<p>Persistent cerebrospinal fluid (CSF) antibodies against the N-methyl-D-aspartate receptor (NMDAR) are common in children recovering from anti-NMDAR encephalitis, but their association with long-term clinical outcomes remains unclear. This study aimed to assess whether persistent CSF NMDAR antibodies at 12 months after diagnosis predict long-term clinical outcomes.</p>Methods<p>In this retrospective observational cohort study, we included patients diagnosed with pediatric anti-NMDAR encephalitis between November 2012 and January 2026. Participants were stratified into two groups according to their CSF NMDAR antibody status at the 12-month follow-up. Clinical characteristics were compared between the groups, and long-term seizure-free rates were assessed using Kaplan–Meier survival analysis.</p>Results<p>Among 162 initially identified patients, 41 (25.3%) met the inclusion criteria (mean age 8.7 ± 4.2 years; 78.0% female). At 12 months, CSF NMDAR antibodies remained detectable in 68.3% (28/41) of patients. Although the antibody-persistent group showed a trend toward a higher relapse rate than the antibody-negative group (42.9% vs. 0%), this difference did not reach statistical significance (P = 0.053). In contrast, the antibody-persistent group required significantly more frequent first-line (57.1% vs. 7.7%, P = 0.003) and second-line (39.3% vs. 0%, P = 0.024) immunotherapy.</p><p>Survival analysis revealed no statistically significant difference in seizure-free rates between the two groups during long-term follow-up (median 26 months; log-rank P = 0.601).</p>Conclusion<p>In pediatric anti-NMDAR encephalitis, persistent CSF NMDAR antibodies at 12 months serve as a marker of incomplete remission and are associated with a trend toward a higher relapse rate and a significantly greater need for intensified immunotherapy, and may help identify patients who would benefit from more intensive immunomodulatory therapy.</p> 2026-10-01T04:31:58Z Image Figure 10.3389/fimmu.2026.1938331.s001 https://figshare.com/articles/figure/Supplementary_file_1_Predictive_value_of_persistent_cerebrospinal_fluid_antibodies_at_12_months_for_long-term_clinical_outcomes_in_pediatric_anti-NMDAR_encephalitis_a_retrospective_cohort_study_jpg/34038210 CC BY 4.0