{
  "abstract": "Background\n\nWhile autoimmune encephalitis (AE) outcomes vary, serostatus-specific prognostic determinants and institutional clustering effects remain poorly characterized. We aimed to delineate the distinct prognostic architecture of AE, identifying serostatus-specific risk factors and potential therapeutic windows.Methods\n\nThis multicenter, retrospective cohort study (2016-2024) included 498 patients (382 antibody-positive [Ab+], 116 antibody-negative [Ab-]) across 11 tertiary centers. The primary endpoint was 1-year poor functional outcome (mRS > 2). We utilized Least Absolute Shrinkage and Selection Operator (LASSO) regression and generalized linear mixed models (GLMM) to adjust for institutional clustering, alongside phenotype-treatment interaction analyses.Results\n\nPoor outcomes occurred in 12.9% of patients. GLMM analysis demonstrated negligible institutional heterogeneity. Prognostic architectures diverged by serostatus: Ab+ outcomes were dictated by failure to achieve early functional remission (discharge mRS: OR = 3.74; CASE: OR = 1.56; both p < 0.01) and age ≥ 65 years (OR = 5.78, p = 0.040). Conversely, Ab- outcomes were independent of discharge severity metrics, driven by baseline demographic and phenotypic features: age ≥ 65 and atypical presentation. Crucially, clinical phenotype modified the therapeutic response (pinteraction = 0.025). Delayed immunotherapy (≥ 30 days) significantly increased poor outcome risk in atypical presentations (OR = 9.16, p = 0.025) but not in canonical phenotypes. A derived prognostic nomogram yielded excellent discrimination (AUC = 0.909).Discussion\n\nLong-term AE outcomes are dictated by patient-level clinical severity and phenotype, with negligible influence from institutional variations. These findings advocate for a serostatus- and phenotype-stratified management strategy. Crucially, atypical presentations exhibit a highly time-dependent therapeutic window requiring rapid immunotherapy, while elderly patients warrant prioritized intervention to mitigate inherent baseline risks.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.",
    "Department of Neurology, People's Hospital of Hongze District, Huaian, China.",
    "Department of Medical Records, Nanjing Brain Hospital, Nanjing, China.",
    "Department of Neurology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China.",
    "Department of Neurology, Xuzhou Central Hospital, Xuzhou, China.",
    "Department of Neurology, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, Huai'an, China.",
    "Department of Neurology, Yancheng First People's Hospital, Yancheng, China.",
    "Department of Neurology, The Fourth Affiliated Hospital of Soochow University, Suzhou, China.",
    "Department of Oncology, The First Affiliated Hospital of Shandong First Medical University, Jinan, China.",
    "Department of Geriatric Medicine, Nanjing Brain Hospital, Nanjing, China.",
    "Department of Neurology, Xuzhou Mining Group General Hospital, Xuzhou, China.",
    "Department of Neurology, Yancheng Third People's Hospital, Yancheng, China.",
    "Department of Neurology, First People's Hospital of Xuzhou, Xuzhou, China.",
    "Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.",
    "School of Public Health, Xuzhou Medical University, Xuzhou, China.",
    "Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 18,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Xiaohong Tang"
    },
    {
      "affs": [
        2
      ],
      "name": "Jingxian Wang"
    },
    {
      "affs": [
        3
      ],
      "name": "Kaixin Zhu"
    },
    {
      "affs": [
        4
      ],
      "name": "Zhen Zhang"
    },
    {
      "affs": [
        5
      ],
      "name": "Liao Wu"
    },
    {
      "affs": [
        6
      ],
      "name": "Wei Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Chang Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Qingyun Li"
    },
    {
      "affs": [
        7
      ],
      "name": "Hao Li"
    },
    {
      "affs": [
        8
      ],
      "name": "Jinghua Chen"
    },
    {
      "affs": [
        4
      ],
      "name": "Zhangxu Lian"
    },
    {
      "affs": [
        9
      ],
      "name": "Bin Liu"
    },
    {
      "affs": [
        10
      ],
      "name": "Tengfei Liu"
    },
    {
      "affs": [
        11
      ],
      "name": "Chunmei Wen"
    },
    {
      "affs": [
        12
      ],
      "name": "Nuan Wang"
    },
    {
      "affs": [
        3,
        13
      ],
      "name": "Sen Qun"
    },
    {
      "affs": [
        14
      ],
      "name": "Lishun Xiao"
    },
    {
      "affs": [
        0,
        15
      ],
      "name": "Qingwei Lai",
      "orcid": "0000-0001-9805-6894"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5kqdpgcw6zd4d.bib",
  "cited_by": 0,
  "doi": "10.1002/acn3.70571",
  "fulltext_url": "https://europepmc.org/articles/PMC13716874",
  "id": "5kqdpgcw6zd4d",
  "issns": [
    "2328-9503"
  ],
  "landing_url": "https://europepmc.org/article/MED/42951877",
  "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": [
    [
      "heading",
      "Research Article"
    ],
    [
      "openalex",
      "2728|Autoimmune Neurological Disorders and Treatments"
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  "openalex": "W7224283031",
  "pdf_url": "https://europepmc.org/articles/PMC13716874?pdf=render",
  "pmcid": "PMC13716874",
  "pmid": "42951877",
  "published": "2026-10-28",
  "publisher": "Wiley",
  "ris": "https://research.draconitic.com/paper/5kqdpgcw6zd4d.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:33Z",
      "native_id": "MED:42951877",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42951877"
    },
    {
      "first_seen": "2026-11-02T12:21:17Z",
      "native_id": "PMC13716874",
      "source": "pmc",
      "url": "https://doi.org/10.1002/acn3.70571"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2728|Autoimmune Neurological Disorders and Treatments",
      "subfield": "neurology"
    }
  ],
  "title": "Serostatus-Specific Prognostic Profiles and Phenotype-Dependent Therapeutic Windows in Autoimmune Encephalitis: A Multicenter Cohort Study.",
  "title_text": "Serostatus-Specific Prognostic Profiles and Phenotype-Dependent Therapeutic Windows in Autoimmune Encephalitis: A Multicenter Cohort Study.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-02T12:21:17Z",
  "url": "https://research.draconitic.com/paper/5kqdpgcw6zd4d",
  "venue": "Annals of clinical and translational neurology",
  "versions": []
}