OBJECTIVE: To assess the prognostic value of MOG antibodies (abs) in the differential diagnosis of acquired demyelinating syndromes (ADS). METHODS: Clinical course, MRI, MOG-abs, AQP4-abs, and CSF cells and oligoclonal bands (OCB) in children with ADS and 24 months of follow-up were reviewed in this observational prospective multicenter hospital-based study. RESULTS: Two hundred ten children with ADS were included and diagnosed with acute disseminated encephalomyelitis (ADEM) (n = 60), neuromyelitis optica spectrum disorder (NMOSD) (n = 12), clinically isolated syndrome (CIS) (n = 101), and multiple sclerosis (MS) (n = 37) after the first episode. MOG-abs were predominantly found in ADEM (57%) and less frequently in NMOSD (25%), CIS (25%), or MS (8%). Increased MOG-ab titers were associated with younger age (p = 0.0001), diagnosis of ADEM (p = 0.005), increased CSF cell counts (p = 0.011), and negative OCB (p = 0.012). At 24-month follow-up, 96 children had no further relapses. Thirty-five children developed recurrent non-MS episodes (63% MOG-, 17% AQP4-abs at onset). Seventy-nine children developed MS (4% MOG-abs at onset). Recurrent non-MS episodes were associated with high MOG-ab titers (p = 0.0003) and older age at onset (p = 0.024). MS was predicted by MS-like MRI (p < 0.0001) and OCB (p = 0.007). An MOG-ab cutoff titer ≥1:1,280 predicted a non-MS course with a sensitivity of 47% and a specificity of 100% and a recurrent non-MS course with a sensitivity of 46% and a specificity of 86%. CONCLUSIONS: Our results show that the presence of MOG-abs strongly depends on the age at disease onset and that high MOG-ab titers were associated with a recurrent non-MS disease course.
OBJECTIVE: To assess the prognostic value of MOG antibodies (abs) in the differential diagnosis of acquired demyelinating syndromes (ADS). METHODS: Clinical course, MRI, MOG-abs, AQP4-abs, and CSF cells and oligoclonal bands (OCB) in children with ADS and 24 months of follow-up were reviewed in this observational prospective multicenter hospital-based study. RESULTS: Two hundred ten children with ADS were included and diagnosed with acute disseminated encephalomyelitis (ADEM) (n = 60), neuromyelitis optica spectrum disorder (NMOSD) (n = 12), clinically isolated syndrome (CIS) (n = 101), and multiple sclerosis (MS) (n = 37) after the first episode. MOG-abs were predominantly found in ADEM (57%) and less frequently in NMOSD (25%), CIS (25%), or MS (8%). Increased MOG-ab titers were associated with younger age (p = 0.0001), diagnosis of ADEM (p = 0.005), increased CSF cell counts (p = 0.011), and negative OCB (p = 0.012). At 24-month follow-up, 96 children had no further relapses. Thirty-five children developed recurrent non-MS episodes (63% MOG-, 17% AQP4-abs at onset). Seventy-nine children developed MS (4% MOG-abs at onset). Recurrent non-MS episodes were associated with high MOG-ab titers (p = 0.0003) and older age at onset (p = 0.024). MS was predicted by MS-like MRI (p < 0.0001) and OCB (p = 0.007). An MOG-ab cutoff titer ≥1:1,280 predicted a non-MS course with a sensitivity of 47% and a specificity of 100% and a recurrent non-MS course with a sensitivity of 46% and a specificity of 86%. CONCLUSIONS: Our results show that the presence of MOG-abs strongly depends on the age at disease onset and that high MOG-ab titers were associated with a recurrent non-MS disease course.
Authors: Divyanshu Dubey; Sean J Pittock; Karl N Krecke; Padraig P Morris; Elia Sechi; Nicholas L Zalewski; Brian G Weinshenker; Eslam Shosha; Claudia F Lucchinetti; James P Fryer; A Sebastian Lopez-Chiriboga; John C Chen; Jiraporn Jitprapaikulsan; Andrew McKeon; Avi Gadoth; B Mark Keegan; Jan-Mendelt Tillema; Elie Naddaf; Marc C Patterson; Kevin Messacar; Kenneth L Tyler; Eoin P Flanagan Journal: JAMA Neurol Date: 2019-03-01 Impact factor: 18.302
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Authors: Matthias Baumann; Astrid Grams; Tanja Djurdjevic; Eva-Maria Wendel; Christian Lechner; Bettina Behring; Astrid Blaschek; Katharina Diepold; Astrid Eisenkölbl; Joel Fluss; Michael Karenfort; Johannes Koch; Bahadir Konuşkan; Steffen Leiz; Andreas Merkenschlager; Daniela Pohl; Mareike Schimmel; Charlotte Thiels; Barbara Kornek; Kathrin Schanda; Markus Reindl; Kevin Rostásy Journal: J Neurol Date: 2018-02-08 Impact factor: 4.849
Authors: D H Whittam; V Karthikeayan; E Gibbons; R Kneen; S Chandratre; O Ciccarelli; Y Hacohen; J de Seze; K Deiva; R Q Hintzen; B Wildemann; S Jarius; I Kleiter; K Rostasy; P Huppke; B Hemmer; F Paul; O Aktas; A K Pröbstel; G Arrambide; M Tintore; M P Amato; M Nosadini; M M Mancardi; M Capobianco; Z Illes; A Siva; A Altintas; G Akman-Demir; L Pandit; M Apiwattankul; J Y Hor; S Viswanathan; W Qiu; H J Kim; I Nakashima; K Fujihara; S Ramanathan; R C Dale; M Boggild; S Broadley; M A Lana-Peixoto; D K Sato; S Tenembaum; P Cabre; D M Wingerchuk; B G Weinshenker; B Greenberg; M Matiello; E C Klawiter; J L Bennett; A I Wallach; I Kister; B L Banwell; A Traboulsee; D Pohl; J Palace; M I Leite; M Levy; R Marignier; T Solomon; M Lim; S Huda; A Jacob Journal: J Neurol Date: 2020-07-04 Impact factor: 4.849
Authors: John J Chen; Eoin P Flanagan; Jiraporn Jitprapaikulsan; Alfonso Sebastian S López-Chiriboga; James P Fryer; Jacqueline A Leavitt; Brian G Weinshenker; Andrew McKeon; Jan-Mendelt Tillema; Vanda A Lennon; W Oliver Tobin; B Mark Keegan; Claudia F Lucchinetti; Orhun H Kantarci; Collin M McClelland; Michael S Lee; Jeffrey L Bennett; Victoria S Pelak; Yanjun Chen; Gregory VanStavern; Ore-Ofe O Adesina; Eric R Eggenberger; Marie D Acierno; Dean M Wingerchuk; Paul W Brazis; Jessica Sagen; Sean J Pittock Journal: Am J Ophthalmol Date: 2018-07-26 Impact factor: 5.258
Authors: A Sebastian López-Chiriboga; Masoud Majed; James Fryer; Divyanshu Dubey; Andrew McKeon; Eoin P Flanagan; Jiraporn Jitprapaikulsan; Naga Kothapalli; Jan-Mendelt Tillema; John Chen; Brian Weinshenker; Dean Wingerchuk; Jessica Sagen; Avi Gadoth; Vanda A Lennon; B Mark Keegan; Claudia Lucchinetti; Sean J Pittock Journal: JAMA Neurol Date: 2018-11-01 Impact factor: 18.302