{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:09:16Z","timestamp":1792066156315,"version":"4.4.0"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T00:00:00Z","timestamp":1775952000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T00:00:00Z","timestamp":1775952000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To characterize the magnetic resonance imaging (MRI) lesion dynamics, comorbidities, predictors of relapse, and outcomes in anti\u2010\n                      <jats:italic>\u03b3<\/jats:italic>\n                      \u2010aminobutyric acid type A receptor (GABA\n                      <jats:sub>A<\/jats:sub>\n                      R) encephalitis, and assess the utility of LIM\u2010domain\u2010only\u2010protein 5 (LMO5) antibodies as tumor markers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      GABA\n                      <jats:sub>A<\/jats:sub>\n                      R antibodies were confirmed by 2 techniques in serum or cerebrospinal fluid. Long\u2010term outcomes were defined as good (modified Rankin scale, mRS\u2009=\u20090\u20131) or poor (mRS 2\u20135) at \u226512\u2009months. LMO5 antibodies were assessed by cell\u2010based assays and Western blot.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010three patients were identified (4 children, 29 adults; median age, 5.5 and 60\u2009years; 61% male). Ten patients (10\/32, 31%) had concurrent systemic autoimmunity. Adults presented with seizures and cognitive\/behavioral symptoms, often with thymoma, gastrointestinal, or other tumors (18\/33, 55%), whereas children frequently had seizures and ataxia with cerebellar MRI lesions. Multifocal T2\/fluid\u2010attenuated inversion recovery hyperintensities were present at onset in 23 of 31 (74%) or developed later in those with absent or single lesions. Lesions showed dynamic changes, suggesting ongoing inflammation even without clinical correlate. Relapses occurred in 17 of 31 (55%, all adults) and were associated with older age (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) and lack of second\u2010line immunotherapy (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). Four patients (4\/33, 12%) died. After a 32.5\u2010month median follow\u2010up, 9 of 20 (45%) had persistent cognitive deficits, and 6 of 20 (30%) had a poor outcome, which was associated with relapses (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). LMO5 antibodies were absent in patients and controls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>\n                      Anti\u2010GABA\n                      <jats:sub>A<\/jats:sub>\n                      R encephalitis shows age\u2010dependent presentations, most commonly seizures. MRI reveals dynamic changes consistent with an ongoing \u201cclinically silent\u201d inflammation. Relapses and cognitive sequelae are common and associate with not receiving second\u2010line immunotherapy. LMO5 antibodies lack tumor\u2010predictive value. ANN NEUROL 2026;100:139\u2013150\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ana.78208","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T03:53:08Z","timestamp":1776052388000},"page":"139-150","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Relapses, Comorbidities, and Predictors of Outcome in Anti\u2010\n                    <scp>\n                      GABA\n                      <sub>A<\/sub>\n                    <\/scp>\n                    Receptor Encephalitis"],"prefix":"10.1002","volume":"100","author":[{"given":"Claudia","family":"Papi","sequence":"first","affiliation":[{"name":"Neuroimmunology Program, Fundaci\u00f3 de Recerca Cl\u00ednic Barcelona\u2010Institut d'Investigacions Biom\u00e9diques August Pi i Sunyer (FRCB\u2010IDIBAPS) University of Barcelona and Caixa Research Institute (CRI)  Barcelona Spain"},{"name":"Department of Neuroscience Catholic University of the Sacred Heart  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Milano","sequence":"additional","affiliation":[{"name":"Neuroimmunology Program, Fundaci\u00f3 de Recerca Cl\u00ednic Barcelona\u2010Institut d'Investigacions Biom\u00e9diques August Pi i Sunyer (FRCB\u2010IDIBAPS) University of Barcelona and Caixa Research Institute (CRI)  Barcelona Spain"},{"name":"Department of Clinical and Experimental Medicine University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2385-5370","authenticated-orcid":false,"given":"Laura","family":"Marmolejo","sequence":"additional","affiliation":[{"name":"Neuroimmunology Program, Fundaci\u00f3 de Recerca Cl\u00ednic Barcelona\u2010Institut d'Investigacions Biom\u00e9diques August Pi i Sunyer (FRCB\u2010IDIBAPS) University of Barcelona and Caixa Research Institute (CRI)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Beatriz","family":"Serafim","sequence":"additional","affiliation":[{"name":"Neuroimmunology Program, Fundaci\u00f3 de Recerca Cl\u00ednic Barcelona\u2010Institut d'Investigacions Biom\u00e9diques August Pi i Sunyer (FRCB\u2010IDIBAPS) University of Barcelona and Caixa Research Institute (CRI)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Aguilar","sequence":"additional","affiliation":[{"name":"Neuroimmunology Program, Fundaci\u00f3 de Recerca Cl\u00ednic Barcelona\u2010Institut d'Investigacions Biom\u00e9diques August Pi i Sunyer (FRCB\u2010IDIBAPS) University of Barcelona and Caixa Research Institute (CRI)  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar","family":"Guasp","sequence":"additional","affiliation":[{"name":"Neuroimmunology Program, Fundaci\u00f3 de Recerca Cl\u00ednic Barcelona\u2010Institut d'Investigacions Biom\u00e9diques August Pi i Sunyer (FRCB\u2010IDIBAPS) University of Barcelona and Caixa Research Institute (CRI)  Barcelona Spain"},{"name":"Neurology Service Hospital Cl\u00ednic de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elianet","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Neuroimmunology Program, Fundaci\u00f3 de Recerca Cl\u00ednic Barcelona\u2010Institut d'Investigacions Biom\u00e9diques August Pi i Sunyer (FRCB\u2010IDIBAPS) University of Barcelona and Caixa Research Institute (CRI)  Barcelona Spain"},{"name":"Pediatric Neuroimmunology Unit, Neurology Service, Sant Joan de D\u00e9u (SJD) Children's Hospital, ERN\u2010RITA Center University of Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mateus Mistieri","family":"Simabukuro","sequence":"additional","affiliation":[{"name":"Division of Neurology, Hospital das Clinicas and C\u00e2ncer do Estado de Sao Paulo Universidade de Sao Paulo  S\u00e3o Paulo Brazil"},{"name":"Instituto do Cancer do Estado de Sao Paulo ICESP, Faculdade de Medicina FMUSP Universidade de Sao Paulo  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6270-0956","authenticated-orcid":false,"given":"Raffaele","family":"Iorio","sequence":"additional","affiliation":[{"name":"Department of Neuroscience Catholic University of the Sacred Heart  Rome Italy"},{"name":"Neurology Unit Fondazione Policlinico Universitario A. 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