Longitudinal Changes in Structural and Functional Brain Imaging and Their Association with Cognitive and Neuropsychiatric Symptoms in Hashimoto Encephalopathy with Anti-NAE Antibody
Abstract
-terminal α-enolase (anti-NAE) antibodies using detailed imaging and neuropsychological assessments. We present the case of a man in his 50s who presented with acute hallucinations, catatonia, seizures, and cognitive decline. Initial MRI revealed diffuse white matter hyperintensities, and SPECT revealed widespread hypoperfusion. These symptoms improved with immunotherapy, but progressive frontal and temporal atrophy and residual hypoperfusion appeared over 33 months. His cognitive function improved, but he remained impaired, with persistent disinhibition and perseveration. This case suggests that Hashimoto's encephalopathy with anti-NAE antibodies can cause lasting structural and functional brain abnormalities and cognitive impairments, requiring long-term neuroimaging and neuropsychological follow-up.
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BibTeX
@article{akahane2026longitudinal,
title = {{Longitudinal Changes in Structural and Functional Brain Imaging and Their Association with Cognitive and Neuropsychiatric Symptoms in Hashimoto Encephalopathy with Anti-NAE Antibody}},
author = {Takaki Akahane and Yuko Yamaguchi and Ryota Kobayashi and Shohei Kawai and Masakazu Akiho and Naomi Takahashi and Toshinori Shirata and Akihito Suzuki},
journal = {Internal Medicine},
year = {2026},
month = aug,
doi = {10.2169/internalmedicine.6395-25},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/65/15/65_6395-25/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Longitudinal Changes in Structural and Functional Brain Imaging and Their Association with Cognitive and Neuropsychiatric Symptoms in Hashimoto Encephalopathy with Anti-NAE Antibody
AU - Takaki Akahane
AU - Yuko Yamaguchi
AU - Ryota Kobayashi
AU - Shohei Kawai
AU - Masakazu Akiho
AU - Naomi Takahashi
AU - Toshinori Shirata
AU - Akihito Suzuki
PY - 2026
DA - 2026/08/01
JO - Internal Medicine
DO - 10.2169/internalmedicine.6395-25
UR - https://www.jstage.jst.go.jp/article/internalmedicine/65/15/65_6395-25/_article
AB - -terminal α-enolase (anti-NAE) antibodies using detailed imaging and neuropsychological assessments. We present the case of a man in his 50s who presented with acute hallucinations, catatonia, seizures, and cognitive decline. Initial MRI revealed diffuse white matter hyperintensities, and SPECT revealed widespread hypoperfusion. These symptoms improved with immunotherapy, but progressive frontal and temporal atrophy and residual hypoperfusion appeared over 33 months. His cognitive function improved, but he remained impaired, with persistent disinhibition and perseveration. This case suggests that Hashimoto's encephalopathy with anti-NAE antibodies can cause lasting structural and functional brain abnormalities and cognitive impairments, requiring long-term neuroimaging and neuropsychological follow-up.
SN - 1349-7235
SN - 0918-2918
ER -