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Structural connectome analysis with graph-based investigations of network properties allows for an in-depth characterization of global and local network changes and their relationship with clinical deficits in NMDAR encephalitis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Structural networks from 61 NMDAR encephalitis patients in the post-acute stage (median time from acute hospital discharge: 18 months) and 61 age- and sex-matched healthy controls (HC) were analyzed using diffusion-weighted imaging (DWI)-based probabilistic anatomically constrained tractography and volumetry of a selection of subcortical and white matter brain volumes was performed. We calculated global, modular, and nodal graph measures with special focus on default-mode network, medial temporal lobe, and hippocampus. Pathologically altered metrics were investigated regarding their potential association with clinical course, disease severity, and cognitive outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients with NMDAR encephalitis showed regular global graph metrics, but bilateral reductions of hippocampal node strength (left:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.049; right:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013) and increased node strength of right precuneus (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013) compared to HC. Betweenness centrality was decreased for left-sided entorhinal cortex (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.042) and left caudal middle frontal gyrus (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037). Correlation analyses showed a significant association between reduced left hippocampal node strength and verbal long-term memory impairment (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021). We found decreased left (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013) and right (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) hippocampal volumes that were associated with hippocampal node strength (left\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009; right\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Focal network property changes of the medial temporal lobes indicate hippocampal hub failure that is associated with memory impairment in NMDAR encephalitis at the post-acute stage, while global structural network properties remain unaltered. Graph theory analysis provides new pathophysiological insight into structural network changes and their association with persistent cognitive deficits in NMDAR encephalitis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00415-024-12545-4","type":"journal-article","created":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T14:02:46Z","timestamp":1720447366000},"page":"5886-5898","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Hippocampal hub failure is linked to long-term memory impairment in anti-NMDA-receptor encephalitis: insights from structural connectome graph theoretical network analysis"],"prefix":"10.1007","volume":"271","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1172-2204","authenticated-orcid":false,"given":"Andr\u00e9","family":"Hechler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7981-2073","authenticated-orcid":false,"given":"Joseph","family":"Kuchling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6388-9375","authenticated-orcid":false,"given":"Leonie","family":"M\u00fcller-Jensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Klag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6378-0070","authenticated-orcid":false,"given":"Friedemann","family":"Paul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8283-7976","authenticated-orcid":false,"given":"Harald","family":"Pr\u00fcss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7665-1171","authenticated-orcid":false,"given":"Carsten","family":"Finke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,8]]},"reference":[{"key":"12545_CR1","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1002\/ana.21050","volume":"61","author":"J Dalmau","year":"2008","unstructured":"Dalmau J, T\u00fcz\u00fcn E, Wu H et al (2008) Paraneoplastic anti\u2013N-methyl-D-aspartate receptor encephalitis associated with ovarian teratoma. 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