Josephine Heine

Charité Universitätsmedizin Berlin | Charité · Neurology, Neurosurgery and Psychiatry

This case report describes a patient who presented with headache, fever, quadriparesis, and reduced visual acuity in the left eye and 6 months later presented with persistent quadriparesis and new-onset cognitive deficits.

Background: Post-COVID syndrome is a severe long-term complication of COVID-19. Although fatigue and cognitive complaints are the most prominent symptoms, it is unclear whether they have structural correlates in the brain. We therefore explored the clinical characteristics of post-COVID fatigue, describe associated structural imaging changes, and...

Background: Neurological symptoms, in particular cognitive deficits, are common in post-COVID-19 syndrome (PCS). There is no approved therapy available, and the underlying disease mechanisms are largely unknown. Besides others, autoimmune processes may play a key role. Design: We here present data of a prospective study conducted between Septemb...

Zusammenfassung Der Nachweis von Autoantikörpern gegen Nerven- oder Gliazellen ermöglicht heute bei zahlreichen neurologischen und psychiatrischen Symptomkomplexen die frühe und spezifische Diagnose einer Autoimmunenzephalitis. Damit hat sich auch die Herangehensweise an die immuntherapeutische Behandlung dieser Krankheitsgruppe fundamental verände...

Patients with anti‐NMDA receptor encephalitis suffer from a severe neuropsychiatric syndrome, yet most patients show no abnormalities in routine magnetic resonance imaging. In contrast, advanced neuroimaging studies have consistently identified disrupted functional connectivity in these patients, with recent work suggesting increased volatility of...

Background Patients with anti-NMDA receptor (NMDAR) encephalitis suffer from a severe neuropsychiatric syndrome, yet most patients show no abnormalities in routine magnetic resonance imaging (MRI). In contrast, advanced neuroimaging studies have consistently identified disrupted functional connectivity in these patients, with recent work suggesting...

Traditional static functional connectivity analyses have shown distinct functional network alterations in patients with anti-N-methyl-d-aspartate receptor encephalitis. Here, we use a dynamic functional connectivity approach that increases the temporal resolution of connectivity analyses from minutes to seconds. We hereby explore the spatiotemporal...

Objective Cognitive dysfunction is a core symptom of NMDAR encephalitis, but detailed studies on prevalence, characteristics of cognitive deficits, and the potential for recovery are missing. Here, we performed a prospective longitudinal study to assess cognitive long-term outcome and identify clinical predictors. Methods Standardized comprehensiv...

Die Autoimmunenzephalitis ist eine kürzlich beschriebene entzündliche Erkrankung des zentralen Nervensystems, die Gedächtnisdefizite, Psychosen, oder epileptische Anfälle hervorrufen kann. Derzeit ist hingegen noch nicht ausreichend verstanden, welche pathologischen Veränderungen zu den kognitiven Defiziten führen und welche neuropsychologischen un...

Hippocampal damage and associated cognitive deficits are frequently observed in neuroimmunological disorders, but comparative analyses to identify shared hippocampal damage patterns are missing. Here, we adopted a transdiagnostic analytical approach and investigated hippocampal shape deformations and associated cognitive deficits in four neuroimmun...

Anti-NMDA receptor (NMDAR) encephalitis is a neuroinflammatory disease that targets the NR1 subunit of the NMDA receptor. The highest density of this receptor is found in the CA1 and subiculum subregions of the hippocampus. Patients frequently experience long-lasting memory and executive dysfunction, even years after the acute disease symptoms - su...

Objective: Multiple sclerosis (MS) is characterized by impairments in basic cognitive functions such as information processing speed as well as in more complex, higher-order domains such as social cognition. However, as these deficits often co-occur, it has remained challenging to determine whether they have a specific pathological basis or are dri...

Introduction: Anti-N-methyl-d-aspartate receptor encephalitis (NMDARE) is an autoimmune disorder associated with severe neuropsychiatric symptoms. While patients with NMDARE exhibit disrupted functional connectivity (FC), these findings have been limited to static connectivity analyses. This study applies time-resolved FC analysis to explore the te...

Background. Cognitive impairments are common in people with multiple sclerosis (MS). Systematic reviews reported promising evidence for various cognitive interventions in this population. Computerized cognitive training (CCT) has strong evidence for safety and efficacy in several populations, but its effects in MS have yet to be specified. Objectiv...

Bei einer stetig wachsenden Zahl von neurologischen Erkrankungen spielen Autoimmunität und Autoantikörper eine Rolle. Mit der therapeutischen Apherese (TA) können autoimmunpathogenetisch relevante Bestandteile aus dem Blut des Patienten direkt und rasch entfernt werden. Die TA kommt häufig dann zum Einsatz, wenn in einer akuten Krankheitssituation...

Hippocampal shape deformations are common across neuro-immunological immunological diseases and contribute to cognitive symptoms. Our comparative approach reveals that the subicular and anterior surfaces corresponding to CA 1-3 are most vulnerable to CNS neuroinflammation - despite the distinct pathomechanisms in multiple sclerosis and the autoimmu...

Objective Hippocampal inflammation in anti-LGI1 encephalitis causes memory deficits, seizures and behavioural abnormalities. Recent findings suggest that extralimbic brain areas are additionally affected and that patients also suffer from non-limbic cognitive symptoms. Moreover, up to 60% of patients show no structural MRI abnormalities in the acut...

Objective: Since recent studies suggested a role of the striatum and prefrontal cortex for multiple sclerosis (MS)-related fatigue, we investigated resting-state functional connectivity alterations of striatal subdivisions and the dorsolateral prefrontal cortex (dlPFC). Methods: Resting-state functional magnetic resonance imaging was acquired in...

[Full-text view-only version: http://rdcu.be/kcp1] Therapeutic apheresis has emerged as a major treatment option for autoantibody-associated inflammatory diseases of the nervous system. This includes patients with autoimmune encephalitides caused by antibodies against neuronal proteins. Plasma exchange (PE) and immunoadsorption (IA) constitute two...

Importance: Limbic encephalitis with leucine-rich, glioma-inactivated 1 (LGI1) antibodies is one of the most frequent variants of autoimmune encephalitis with antibodies targeting neuronal surface antigens. However, the neuroimaging pattern and long-term cognitive outcome are not well understood. Objective: To study cognitive outcome and structu...

Objective: To assess volumes and microstructural integrity of deep gray matter structures in a homogeneous cohort of patients with neuromyelitis optica spectrum disorder (NMOSD). Methods: This was a cross-sectional study including 36 aquaporin-4 antibody-positive (AQP4 Ab-positive) Caucasian patients with NMOSD and healthy controls matched for a...

The field of autoimmune encephalitides associated with antibodies targeting cell-surface antigens is rapidly expanding and new antibodies are discovered frequently. Typical clinical presentations include cognitive deficits, psychiatric symptoms, movement disorders and seizures and the majority of patients responds well to immunotherapy. Pathophysio...