{
  "abstract": "Background and objective: 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.\n\nMethods: 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.\n\nResults: 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.\n\nSurvival 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).\n\nConclusion: 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.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Pediatrics, West China Second University Hospital, Sichuan University , , ,"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Hua Yang"
    },
    {
      "affs": [
        0
      ],
      "name": "Ruling Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Jie Yang"
    },
    {
      "affs": [
        0
      ],
      "name": "Jingui Zhao"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiaoling Zhong"
    },
    {
      "affs": [
        0
      ],
      "name": "Rong Luo"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2xc62dg46r2fp.bib",
  "cited_by": 0,
  "doi": "10.3389/fimmu.2026.1938331",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668519/?tool=EBI",
  "id": "2xc62dg46r2fp",
  "issns": [
    "1664-3224"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13668519",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2728|Autoimmune Neurological Disorders and Treatments"
    ]
  ],
  "openalex": "W7215096153",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668519/pdf/?tool=EBI",
  "pmcid": "PMC13668519",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/2xc62dg46r2fp.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:18Z",
      "native_id": "PMC:PMC13668519",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13668519"
    },
    {
      "first_seen": "2026-10-30T12:19:15Z",
      "native_id": "10.3389/fimmu.2026.1938331",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1938331/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2728|Autoimmune Neurological Disorders and Treatments",
      "subfield": "neurology"
    }
  ],
  "title": "Predictive value of persistent cerebrospinal fluid antibodies at 12 months for long-term clinical outcomes in pediatric anti-NMDAR encephalitis: a retrospective cohort study",
  "title_text": "Predictive value of persistent cerebrospinal fluid antibodies at 12 months for long-term clinical outcomes in pediatric anti-NMDAR encephalitis: a retrospective cohort study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:15Z",
  "url": "https://research.draconitic.com/paper/2xc62dg46r2fp",
  "venue": "Frontiers in immunology",
  "versions": []
}