Y Zhou1, X Jia2, H Yang3, C Chen1, X Sun1, L Peng1, A G Kermode1,4,5,6, W Qiu1. 1. Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. 2. Department of Ophthalmology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. 3. Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. 4. Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Perth, WA, Australia. 5. Department of Neurology, Sir Charles Gairdner Hospital, Queen Elizabeth II Medical Centre, Perth, WA, Australia. 6. Institute of Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia.
Abstract
BACKGROUND AND PURPOSE: The aim of this study was to analyse the clinical and prognostic features of myelin oligodendrocyte glycoprotein (MOG) antibody-associated demyelination with different onset phenotypes. METHODS: A total of 52 MOG-IgG-seropositive patients were divided into four groups: (i) optic neuritis (ON) at onset (MOG-ON+ , n = 23), (ii) transverse myelitis (TM) at onset (MOG-TM+ , n = 12), (iii) pure brain symptoms at onset (MOG-ON- -TM- , n = 14) and (iv) both ON and TM at onset (n = 3). This final group was not included in further analyses. Data were collected through medical records and regular follow-up. RESULTS: Median age at presentation was 24 (range, 3-63) years in the whole cohort (50% female). MOG-ON- -TM- patients had the youngest age of onset across the three groups. Patients with MOG-TM+ tended to relapse more frequently and had a longer interval to first relapse than was observed in MOG-ON+ and MOG-ON- -TM- patients. High MOG-IgG titres were associated with increased cerebrospinal fluid leukocytes. The likelihood of harbouring transient, low MOG-IgG titres was higher in the MOG-TM+ group than in the other groups. After a median disease duration of 20 months, most but not all cases had a favourable outcome, with 8% developing severe visual deficit, 2% becoming wheelchair-dependent and 6% developing cognitive impairment. The onset phenotype appeared to be an important predictor of disability type. Having high MOG-IgG titres (odds ratio, 0.168, P = 0.027) or female gender (odds ratio, 0.270, P = 0.067) was associated with a lower likelihood of complete recovery. CONCLUSIONS: Onset phenotype may influence long-term presentation, MOG-IgG status as well as outcome. Further large and prospective studies are needed to better clarify the clinical implications of the first demyelinating event.
BACKGROUND AND PURPOSE: The aim of this study was to analyse the clinical and prognostic features of myelin oligodendrocyte glycoprotein (MOG) antibody-associated demyelination with different onset phenotypes. METHODS: A total of 52 MOG-IgG-seropositive patients were divided into four groups: (i) optic neuritis (ON) at onset (MOG-ON+ , n = 23), (ii) transverse myelitis (TM) at onset (MOG-TM+ , n = 12), (iii) pure brain symptoms at onset (MOG-ON- -TM- , n = 14) and (iv) both ON and TM at onset (n = 3). This final group was not included in further analyses. Data were collected through medical records and regular follow-up. RESULTS: Median age at presentation was 24 (range, 3-63) years in the whole cohort (50% female). MOG-ON- -TM- patients had the youngest age of onset across the three groups. Patients with MOG-TM+ tended to relapse more frequently and had a longer interval to first relapse than was observed in MOG-ON+ and MOG-ON- -TM- patients. High MOG-IgG titres were associated with increased cerebrospinal fluid leukocytes. The likelihood of harbouring transient, low MOG-IgG titres was higher in the MOG-TM+ group than in the other groups. After a median disease duration of 20 months, most but not all cases had a favourable outcome, with 8% developing severe visual deficit, 2% becoming wheelchair-dependent and 6% developing cognitive impairment. The onset phenotype appeared to be an important predictor of disability type. Having high MOG-IgG titres (odds ratio, 0.168, P = 0.027) or female gender (odds ratio, 0.270, P = 0.067) was associated with a lower likelihood of complete recovery. CONCLUSIONS: Onset phenotype may influence long-term presentation, MOG-IgG status as well as outcome. Further large and prospective studies are needed to better clarify the clinical implications of the first demyelinating event.
Authors: P P Banerjee; L Pang; S S Soldan; S M Miah; A Eisenberg; S Maru; A Waldman; E A Smith; Y Rosenberg-Hasson; D Hirschberg; A Smith; D V Ablashi; K S Campbell; J S Orange Journal: Mol Immunol Date: 2018-11-24 Impact factor: 4.407
Authors: Ziyan Li; Hong Sun; Xiao Fan; Ping Yuan; Yan Jiang; Peng Wu; Min Zhong; Jiannan Ma; Li Jiang; Xiujuan Li Journal: Front Neurol Date: 2021-03-26 Impact factor: 4.003