MRI cortical thickness in paediatric auto-immune encephalitis and acute disseminated encephalomyelitis

Charly H.A. Billaud; Daniel Griffiths-King; Evangeline Wassmer; Sukhvir Wright; Elaine Foley; Amanda G. Wood

doi:10.1016/j.ejpn.2025.11.001

MRI cortical thickness in paediatric auto-immune encephalitis and acute disseminated encephalomyelitis

Charly H.A. Billaud
, Daniel Griffiths-King^*
, Evangeline Wassmer
, Sukhvir Wright
, Elaine Foley
, Amanda G. Wood

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

Objective: Paediatric autoimmune encephalitis and acute disseminated encephalomyelitis (ADEM) are neuroinflammatory disorders that can cause acute MRI abnormalities. Recent analyses suggest brain volume reductions months to years after disease onset. This study aimed to verify whether decreased gray matter thickness would also be observed in whole-brain cortical thickness as well as in temporal polar and orbitofrontal cortices.

Methods: A cohort of children previously diagnosed with autoimmune encephalitis (including anti- NMDA encephalitis and ADEM) were recruited at least two years after initial presentation and a cohort of typically developing children with no known neurological conditions. Cortical thickness across the whole-brain and in each region-of-interest was measured from T1w MRI scans using Freesurfer.

Results: MRI scans from 12 children with autoimmune encephalitis (mean age = 10.5; 8F:4M) and 48 controls (mean age = 10.7; 23F 25M) were analysed. The autoimmune encephalitis group had lower cortical thickness in a cluster covering the top part of the left superior occipital gyrus and the bottom part of the left superior parietal lobule (cluster size = 681.55 mm2; corrected cluster-wise p = 0.00459; clusterwise Cohen’s d= -8.3773). No multivariate effect on the cortical thickness of the regions-of-interest was found (Roy’s Largest Root = .095, F(df) = 1.207(4); p = .319; partial η2 = .087). A small univariate effect was observed, with autoimmune encephalitis predicting lower left orbitofrontal thickness (F = 4.407, p = .040, Partial η2 = .075).

Interpretation: Children with autoimmune encephalitis may be subject to local cortical thinning in the long term.

Original language	English
Pages (from-to)	36-43
Number of pages	8
Journal	European Journal of Paediatric Neurology
Volume	60
Early online date	11 Nov 2025
DOIs	https://doi.org/10.1016/j.ejpn.2025.11.001
Publication status	Published - 1 Jan 2026

Bibliographical note

Copyright © 2025 The Authors.Published by Elsevier Ltd on behalf of European Paediatric Neurology Society. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/).

Funding

The current study was supported by a European Research Council (ERC) - Consolidator Grant (ERC-CoG) to AW [grant number 682734] and internal grant funding from the Aston Institute of Health and Neurodevelopment, Aston University to AW and DGK. DGK was funded by a Birmingham Women’s and Children’s Hospital Charity Research Fund Grant [BWCHRF572, 37-6-094] to AW, SW & EW. CB was funded by a Silver Jubilee PhD studentship from the Encephalitis Society to AW and SW. The study was also supported by the NIHR Clinical Research Network (CRN), specifically CRN West Midlands.

Keywords

Pediatric
Autoimmune encephalitis
MRI
Cortical thickness

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10.1016/j.ejpn.2025.11.001Licence: CC BY 4.0

CHA Billaud et al_MRI cortical thickness in paediatric auto-immune incephalitis and acute disseminated encephalomyelitis
Copyright © 2025 The Authors.Published by Elsevier Ltd on behalf of European Paediatric Neurology Society. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/).
Final published version, 1.76 MBLicence: CC BY 4.0

Cite this

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title = "MRI cortical thickness in paediatric auto-immune encephalitis and acute disseminated encephalomyelitis",

abstract = "Objective: Paediatric autoimmune encephalitis and acute disseminated encephalomyelitis (ADEM) are neuroinflammatory disorders that can cause acute MRI abnormalities. Recent analyses suggest brain volume reductions months to years after disease onset. This study aimed to verify whether decreased gray matter thickness would also be observed in whole-brain cortical thickness as well as in temporal polar and orbitofrontal cortices. Methods: A cohort of children previously diagnosed with autoimmune encephalitis (including anti- NMDA encephalitis and ADEM) were recruited at least two years after initial presentation and a cohort of typically developing children with no known neurological conditions. Cortical thickness across the whole-brain and in each region-of-interest was measured from T1w MRI scans using Freesurfer. Results: MRI scans from 12 children with autoimmune encephalitis (mean age = 10.5; 8F:4M) and 48 controls (mean age = 10.7; 23F 25M) were analysed. The autoimmune encephalitis group had lower cortical thickness in a cluster covering the top part of the left superior occipital gyrus and the bottom part of the left superior parietal lobule (cluster size = 681.55 mm2; corrected cluster-wise p = 0.00459; clusterwise Cohen{\textquoteright}s d= -8.3773). No multivariate effect on the cortical thickness of the regions-of-interest was found (Roy{\textquoteright}s Largest Root = .095, F(df) = 1.207(4); p = .319; partial η2 = .087). A small univariate effect was observed, with autoimmune encephalitis predicting lower left orbitofrontal thickness (F = 4.407, p = .040, Partial η2 = .075). Interpretation: Children with autoimmune encephalitis may be subject to local cortical thinning in the long term.",

keywords = "Pediatric, Autoimmune encephalitis, MRI, Cortical thickness",

author = "Billaud, \{Charly H.A.\} and Daniel Griffiths-King and Evangeline Wassmer and Sukhvir Wright and Elaine Foley and Wood, \{Amanda G.\}",

note = "Copyright {\textcopyright} 2025 The Authors.Published by Elsevier Ltd on behalf of European Paediatric Neurology Society. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/).",

year = "2026",

month = jan,

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doi = "10.1016/j.ejpn.2025.11.001",

language = "English",

volume = "60",

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TY - JOUR

T1 - MRI cortical thickness in paediatric auto-immune encephalitis and acute disseminated encephalomyelitis

AU - Billaud, Charly H.A.

AU - Griffiths-King, Daniel

AU - Wassmer, Evangeline

AU - Wright, Sukhvir

AU - Foley, Elaine

AU - Wood, Amanda G.

N1 - Copyright © 2025 The Authors.Published by Elsevier Ltd on behalf of European Paediatric Neurology Society. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/).

PY - 2026/1/1

Y1 - 2026/1/1

N2 - Objective: Paediatric autoimmune encephalitis and acute disseminated encephalomyelitis (ADEM) are neuroinflammatory disorders that can cause acute MRI abnormalities. Recent analyses suggest brain volume reductions months to years after disease onset. This study aimed to verify whether decreased gray matter thickness would also be observed in whole-brain cortical thickness as well as in temporal polar and orbitofrontal cortices. Methods: A cohort of children previously diagnosed with autoimmune encephalitis (including anti- NMDA encephalitis and ADEM) were recruited at least two years after initial presentation and a cohort of typically developing children with no known neurological conditions. Cortical thickness across the whole-brain and in each region-of-interest was measured from T1w MRI scans using Freesurfer. Results: MRI scans from 12 children with autoimmune encephalitis (mean age = 10.5; 8F:4M) and 48 controls (mean age = 10.7; 23F 25M) were analysed. The autoimmune encephalitis group had lower cortical thickness in a cluster covering the top part of the left superior occipital gyrus and the bottom part of the left superior parietal lobule (cluster size = 681.55 mm2; corrected cluster-wise p = 0.00459; clusterwise Cohen’s d= -8.3773). No multivariate effect on the cortical thickness of the regions-of-interest was found (Roy’s Largest Root = .095, F(df) = 1.207(4); p = .319; partial η2 = .087). A small univariate effect was observed, with autoimmune encephalitis predicting lower left orbitofrontal thickness (F = 4.407, p = .040, Partial η2 = .075). Interpretation: Children with autoimmune encephalitis may be subject to local cortical thinning in the long term.

AB - Objective: Paediatric autoimmune encephalitis and acute disseminated encephalomyelitis (ADEM) are neuroinflammatory disorders that can cause acute MRI abnormalities. Recent analyses suggest brain volume reductions months to years after disease onset. This study aimed to verify whether decreased gray matter thickness would also be observed in whole-brain cortical thickness as well as in temporal polar and orbitofrontal cortices. Methods: A cohort of children previously diagnosed with autoimmune encephalitis (including anti- NMDA encephalitis and ADEM) were recruited at least two years after initial presentation and a cohort of typically developing children with no known neurological conditions. Cortical thickness across the whole-brain and in each region-of-interest was measured from T1w MRI scans using Freesurfer. Results: MRI scans from 12 children with autoimmune encephalitis (mean age = 10.5; 8F:4M) and 48 controls (mean age = 10.7; 23F 25M) were analysed. The autoimmune encephalitis group had lower cortical thickness in a cluster covering the top part of the left superior occipital gyrus and the bottom part of the left superior parietal lobule (cluster size = 681.55 mm2; corrected cluster-wise p = 0.00459; clusterwise Cohen’s d= -8.3773). No multivariate effect on the cortical thickness of the regions-of-interest was found (Roy’s Largest Root = .095, F(df) = 1.207(4); p = .319; partial η2 = .087). A small univariate effect was observed, with autoimmune encephalitis predicting lower left orbitofrontal thickness (F = 4.407, p = .040, Partial η2 = .075). Interpretation: Children with autoimmune encephalitis may be subject to local cortical thinning in the long term.

KW - Pediatric

KW - Autoimmune encephalitis

KW - MRI

KW - Cortical thickness

UR - https://www.ejpn-journal.com/article/S1090-3798(25)00175-8/fulltext

UR - https://www.scopus.com/pages/publications/105022493096

U2 - 10.1016/j.ejpn.2025.11.001

DO - 10.1016/j.ejpn.2025.11.001

M3 - Article

SN - 1090-3798

VL - 60

SP - 36

EP - 43

JO - European Journal of Paediatric Neurology

JF - European Journal of Paediatric Neurology

ER -

MRI cortical thickness in paediatric auto-immune encephalitis and acute disseminated encephalomyelitis

Abstract

Bibliographical note

Funding

Keywords

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