The Future of Brain Inflammation Care: AI, Autoimmunity, and the Extinguish Trial
Release Date: 05/18/2025
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info_outlineIn this episode of MD Newsline, Dr. Stacey Clardy, a neurologist at the University of Utah and the Salt Lake City VA, shares her expertise in autoimmune neurology, focusing on autoimmune encephalitis—a complex, often misunderstood condition where the immune system attacks the brain. Dr. Clardy explains how symptoms often mimic psychiatric disorders, complicating timely diagnosis and treatment. She also discusses the Extinguish Trial, a groundbreaking NIH-supported clinical study testing a potential treatment for NMDA receptor encephalitis, the most common form of autoimmune encephalitis. Episode Highlights:
Understanding Autoimmune Encephalitis and NMDA ReceptorsAutoimmune encephalitis causes brain inflammation, which can present with psychiatric symptoms like hallucinations, paranoia, or behavioral changes, often leading to misdiagnoses. NMDA receptor encephalitis, the most common type, is triggered in some patients by ovarian teratomas and presents primarily in young women. Dr. Clardy highlights the need for early diagnosis through spinal fluid testing and explains the risks of incorrect treatment—such as immunosuppressing an infectious encephalitis case.
Connecting Neurology, Psychiatry, and the GutDr. Clardy underscores the blurred line between psychiatric and neurologic symptoms, advocating for more collaborative care between specialties. She also emphasizes the role of gut involvement in many autoimmune neurological conditions, noting that nervous system dysfunction often appears alongside gastrointestinal symptoms. This further supports the need for systemic, patient-centered approaches.
The Extinguish Trial: Pioneering Treatment for NMDA Receptor EncephalitisThe Extinguish Trial—sponsored by the NIH and supported by Amgen—is the first major trial testing inebilizumab, a B-cell depleting therapy, in newly diagnosed NMDA receptor encephalitis patients. The study aims to standardize treatment, reduce unnecessary therapies, and track long-term outcomes, caregiver experiences, and biomarkers that could predict disease severity. With no FDA-approved treatments currently available, this trial represents a critical moment in improving care for rare brain inflammation disorders. Key Takeaway
Autoimmune encephalitis often mimics psychiatric illness, making early diagnosis and proper testing critical for effective treatment. The Extinguish Trial marks a major step toward establishing the first FDA-approved therapy for NMDA receptor encephalitis. Collaborative care and personalized approaches are essential in managing this complex, immune-driven brain disorder.
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