Patients suffering from strokes are at increased risk of developing post-stroke dementia. Serum anti-NMDA receptor autoantibodies (NMDAR1-abs) have been associated with unfavorable post-stroke outcomes. However, their effect on specific cognitive domains remains unclear. We used data from the prospective multicenter DZNE—mechanisms after stroke (DEMDAS) cohort, and measured NMDAR1-abs in serum at baseline. Cognitive function was assessed with a comprehensive neuropsychological test battery at 6- and 12-months follow-up. We employed crude and stepwise confounder adjusted linear and logistic regression models as well as generalized estimating equation models (GEE) to determine the relevance of NMDAR1-abs seropositivity on cognitive function after stroke. 10.2% (58/569) DEMDAS patients were NMDAR1-abs seropositive (IgM:n = 44/IgA:n = 21/IgG:n = 2). Seropositivity was not associated with global cognitive impairment after stroke. However, NMDAR1-abs seropositive patients performed lower in the memory domain (β_adjusted = −0.11; 95%CI = −0.57 to −0.03) and were at increased risk for memory impairment (OR_adjusted= 3.8; 95%CI = 1.33–10.82) compared to seronegative patients, 12 months after stroke. Further, NMDAR1-abs were linked to memory impairment over time in GEE from 6- to 12-months follow-up (OR_adjusted= 2.41; 95%CI = 1.05–5.49). Our data suggests that NMDAR1-abs contribute to memory dysfunction 1 year after stroke while not affecting other cognitive subdomains. Hence, antineuronal autoimmunity may be involved in distinct mechanisms of post-stroke memory impairment. Clinical trial name and registration number: The Determinants of Dementia After Stroke (DEMDAS; study identifier on clinical trials.gov: NCT01334749)

中风患者患中风后痴呆的风险增加。血清抗 NMDA 受体自身抗体 （NMDAR1-abs） 与卒中后不良结局相关。然而，它们对特定认知领域的影响仍不清楚。我们使用了来自前瞻性多中心 DZNE—卒中机制 （DEMDAS） 队列的数据，并测量了基线时血清中的 NMDAR1-abs。在 6 个月和 12 个月的随访中，使用综合神经心理学测试组合评估认知功能。我们采用粗略和逐步混杂调整的线性和 logistic 回归模型以及广义估计方程模型 （GEE） 来确定 NMDAR1-abs 血清阳性与中风后认知功能的相关性。10.2% （58/569） 的 DEMDAS 患者为 NMDAR1-abs 血清阳性 （IgM：n = 44/IgA：n = 21/IgG：n = 2）。血清阳性与卒中后整体认知障碍无关。然而，与血清阴性患者相比，NMDAR1-abs 血清阳性患者在记忆领域的表现较低 （β_调整 = -0.11;95%CI = -0.57 至 -0.03），并且记忆障碍的风险增加 （OR_调整 = 3.8;95%CI = 1.33-10.82） 与血清阴性患者相比，中风后 12 个月。此外，从 6 到 12 个月的随访中，NMDAR1-abs 与 GEE 中随时间推移的记忆障碍有关 （OR_调整 = 2.41;95% CI = 1.05-5.49）。我们的数据表明，NMDAR1-abs 会导致中风后 1 年出现记忆功能障碍，而不会影响其他认知子域。因此，抗神经元自身免疫可能参与中风后记忆障碍的不同机制。临床试验名称和注册号：卒中后痴呆的决定因素 （DEMDAS;临床 trials.gov 的研究标识符：NCT01334749）