{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T23:05:06Z","timestamp":1769641506744,"version":"3.49.0"},"reference-count":27,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Brain MRI abnormalities in anti-NMDA receptor encephalitis (ANMDARE) are classically described in limbic structures, particularly the medial temporal lobe. Paralimbic, neocortical, and meningeal abnormalities have been less consistently reported. Objective: The objective was to evaluate the diagnostic value of brain MRI abnormalities in patients with definite ANMDARE. Methods: We conducted a case\u2013control study including 115 patients with ANMDARE and 115 controls with primary psychotic disorders or antibody-negative autoimmune encephalitis. Structural MRI studies were systematically reviewed by an expert neuroradiologist blinded to clinical diagnosis. Results: ANMDARE patients were younger and more frequently presented with seizures, dyskinesia, severe neuropsychiatric disturbances, abnormal cerebrospinal fluid and EEG findings, and worse outcomes, including mortality. T2-T2-FLAIR abnormalities commonly involved medial temporal limbic structures, paralimbic regions (anterior cingulate and insular cortices), and neocortical areas (parieto-occipital cortices). Pachymeningeal enhancement was observed in 26.1% of patients. MRI findings clearly differentiated ANMDARE from primary psychotic disorders but largely overlapped with antibody-negative autoimmune encephalitis, except for limited parietal and occipital differences. Conclusions: T2-FLAIR MRI abnormalities involving medial temporal, paralimbic, and posterior neocortical regions are common in ANMDARE. Pachymeningeal enhancement is not rare. While useful for distinguishing ANMDARE from primary psychotic disorders, a substantial overlap with antibody-negative autoimmune encephalitis was observed.<\/jats:p>","DOI":"10.3390\/diagnostics16030391","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T11:14:07Z","timestamp":1769426047000},"page":"391","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Abnormal Magnetic Resonance Imaging Patterns in Patients with Neuropsychiatric Disorders Due to Anti-NMDA Receptor Encephalitis: A Comparative Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6382-2699","authenticated-orcid":false,"given":"Miguel","family":"Restrepo-Martinez","sequence":"first","affiliation":[{"name":"Neuropsychiatry Unit, National Institute of Neurology and Neurosurgery, Mexico City 14269, Mexico"},{"name":"Neuropsychiatry Unit, Americas Clinic, Medell\u00edn 050001, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8719-4589","authenticated-orcid":false,"given":"Roger","family":"Carrillo-Mezo","sequence":"additional","affiliation":[{"name":"Neuroradiology Service, National Institute of Neurology and Neurosurgery, Mexico City 14269, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8648-889X","authenticated-orcid":false,"given":"Abel","family":"Medina-Islas","sequence":"additional","affiliation":[{"name":"Neuroradiology Service, National Institute of Neurology and Neurosurgery, Mexico City 14269, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5649-7701","authenticated-orcid":false,"given":"Manuel Ricardo","family":"Barojas-Alvarez","sequence":"additional","affiliation":[{"name":"Neuropsychiatry Unit, National Institute of Neurology and Neurosurgery, Mexico City 14269, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9703-3487","authenticated-orcid":false,"given":"Marcela","family":"Otero-Cisneros","sequence":"additional","affiliation":[{"name":"Neuropsychiatry Unit, National Institute of Neurology and Neurosurgery, Mexico City 14269, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco M.","family":"Mart\u00ednez-Carrillo","sequence":"additional","affiliation":[{"name":"Neuropsychiatry Unit, National Institute of Neurology and Neurosurgery, Mexico City 14269, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariana","family":"Esp\u00ednola-Nadurille","sequence":"additional","affiliation":[{"name":"Neuropsychiatry Unit, National Institute of Neurology and Neurosurgery, Mexico City 14269, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ver\u00f3nica","family":"Rivas-Alonso","sequence":"additional","affiliation":[{"name":"Neurology Department, National Institute of Neurology and Neurosurgery, Mexico City 14269, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4823-1556","authenticated-orcid":false,"given":"Victoria","family":"Mart\u00ednez-\u00c1ngeles","sequence":"additional","affiliation":[{"name":"Neuropsychiatry Unit, National Institute of Neurology and Neurosurgery, Mexico City 14269, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arely","family":"Ju\u00e1rez-Jaramillo","sequence":"additional","affiliation":[{"name":"Neuropsychiatry Unit, National Institute of Neurology and Neurosurgery, Mexico City 14269, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6019-3009","authenticated-orcid":false,"given":"Jos\u00e9 de Jes\u00fas","family":"Flores-Rivera","sequence":"additional","affiliation":[{"name":"Neurology Department, National Institute of Neurology and Neurosurgery, Mexico City 14269, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Varela-Blanco","sequence":"additional","affiliation":[{"name":"Neuroradiology Service, National Institute of Neurology and Neurosurgery, Mexico City 14269, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2879-5258","authenticated-orcid":false,"given":"Jes\u00fas","family":"Ramirez-Bermudez","sequence":"additional","affiliation":[{"name":"Neuropsychiatry Unit, National Institute of Neurology and Neurosurgery, Mexico City 14269, Mexico"},{"name":"School of Medicine, National Autonomous University of Mexico, Mexico City 04510, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1093\/cid\/cir1038","article-title":"The Frequency of Autoimmune N-Methyl-D-Aspartate Receptor Encephalitis Surpasses That of Individual Viral Etiologies in Young Individuals Enrolled in the California Encephalitis Project","volume":"54","author":"Gable","year":"2012","journal-title":"Clin. 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