{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:09:14Z","timestamp":1792066154922,"version":"4.4.0"},"reference-count":58,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"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":["Neuropsychopharm Rep"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anti\u2010leucine\u2010rich\u2010glioma\u2010inactivated 1 encephalitis (LGI1e) predominantly affects older adults, who frequently present with chronic comorbidities. Given their heightened susceptibility to adverse effects, optimizing immunotherapy is critical for this high\u2010risk population. Therefore, this study compared the efficacy and safety of intravenous immunoglobulin (IVIg), intravenous methylprednisolone (IVMP) at 500 or 1000\u2009mg\/day, and combined IVIg with IVMP to define an optimal efficacy\u2010safety balanced regimen for LGI1e.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 131 LGI1e patients were comprehensively analyzed. The efficacy was assessed through the therapeutic response rate, response latency, and the improvement in the Clinical Assessment Scale for Autoimmune Encephalitis (CASE), the modified Rankin Scale (mRS), the Mini\u2010Mental State Examination (MMSE), and faciobrachial dystonic seizure (FBDS), while safety was evaluated by analyzing the incidence and severity of adverse events (AEs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with IVIg or IVMP monotherapy, the IVIg+IVMP combination achieved higher response rates, shorter latency, and greater improvements in CASE, mRS, and FBDS. While 1000\u2009mg IVMP reduced response latency and FBDS cessation time versus 500\u2009mg, both doses showed comparable response rates. IVMP\u2010containing regimens increased AEs, especially at 1000\u2009mg. Diabetes was the sole independent AE risk factor during acute immunotherapies. Initial regimens had no long\u2010term outcome association, and cognitive impairment persisted as a major disability contributor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>For LGI1e patients, combined IVIg and corticosteroid demonstrate superior efficacy to monotherapy as first\u2010line treatment, with a starting IVMP dose of 500\u2009mg (vs. 1000\u2009mg) considered optimal. Furthermore, post\u2010immunotherapy cognitive impairment requires sustained management. These findings necessitate validation in larger randomized trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/npr2.70112","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T06:14:48Z","timestamp":1773987288000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Combination Versus Monotherapy in Acute Anti\u2010\n                    <scp>LGI1<\/scp>\n                    Encephalitis: A Real\u2010World Dose Optimization Analysis"],"prefix":"10.1002","volume":"46","author":[{"given":"Yao","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine The Affiliated Brain Hospital of Nanjing Medical University  Nanjing People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine The Affiliated Suqian Hospital of 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