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Maillart E, Deiva K, Marignier R. Clinical characteristics of patients with myelin oligodendrocyte glycoprotein antibodies. Curr Opin Neurol 2024; 37:338-344. [PMID: 38497310 DOI: 10.1097/wco.0000000000001265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
PURPOSE OF REVIEW The clinical landscape associated to myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) has undergone a remarkable transformation over the past two decades, primarily driven by advancements in antibody detection techniques that have enhanced both the specificity and sensitivity of assays, enabling the identification of novel clinical phenotypes. RECENT FINDINGS Recent pivotal research publications, comprehensive reviews from established research groups, and most notably the first proposed international criteria for MOG-Ab associated disease (MOGAD) have substantially enriched our understanding of the clinical features associated with MOG-Ab. This review presents a comprehensive overview of the clinical characteristics of patients with MOG-Ab, systematically examining each core clinical syndrome defined by the proposed international MOGAD criteria. We incorporated recent insights and discussed potential challenges in applying these criteria across diverse clinical scenarios. SUMMARY The proposed international MOGAD criteria provide a comprehensive, homogeneous, and specific framework for characterizing the clinical features of patients with MOG-Ab, encompassing both paediatric and adult populations. In the future, the widespread adoption of specific and reliable assays for MOG-Ab detection, complemented by the development of surrogate fluid and imaging markers, holds promise for better characterizing atypical presentations, only-cerebrospinal fluid positivity and the MOGAD "seronegative" situations.
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Affiliation(s)
- Elisabeth Maillart
- Centre de Référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM)
- Department of Neurology, Hôpital Pitié-Salpêtrière, APHP, Paris
| | - Kumaran Deiva
- Centre de Référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM)
- Department of Pediatric Neurology, Bicêtre Hospital, University Hospitals Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre
| | - Romain Marignier
- Centre de Référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM)
- Service de Neurologie, sclérose en plaques, pathologies de la myéline et neuroinflammation, Hôpital Neurologique P. Wertheimer, Hospices Civils de Lyon, France
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Stefan KA, Ciotti JR. MOG Antibody Disease: Nuances in Presentation, Diagnosis, and Management. Curr Neurol Neurosci Rep 2024:10.1007/s11910-024-01344-z. [PMID: 38805147 DOI: 10.1007/s11910-024-01344-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE OF REVIEW Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) is a distinct neuroinflammatory condition characterized by attacks of optic neuritis, transverse myelitis, and other demyelinating events. Though it can mimic multiple sclerosis and neuromyelitis optica spectrum disorder, distinct clinical and radiologic features which can discriminate these conditions are now recognized. This review highlights recent advances in our understanding of clinical manifestations, diagnosis, and treatment of MOGAD. RECENT FINDINGS Studies have identified subtleties of common clinical attacks and identified more rare phenotypes, including cerebral cortical encephalitis, which have broadened our understanding of the clinicoradiologic spectrum of MOGAD and culminated in the recent publication of proposed diagnostic criteria with a familiar construction to those diagnosing other neuroinflammatory conditions. These criteria, in combination with advances in antibody testing, should simultaneously lead to wider recognition and reduced incidence of misdiagnosis. In addition, recent observational studies have raised new questions about when to treat MOGAD chronically, and with which agent. MOGAD pathophysiology informs some of the relatively unique clinical and radiologic features which have come to define this condition, and similarly has implications for diagnosis and management. Further prospective studies and the first clinical trials of therapeutic options will answer several remaining questions about the peculiarities of this condition.
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Affiliation(s)
- Kelsey A Stefan
- Department of Neurology, University of South Florida, 13330 USF Laurel Drive, Tampa, FL, 33612, USA
| | - John R Ciotti
- Department of Neurology, University of South Florida, 13330 USF Laurel Drive, Tampa, FL, 33612, USA.
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Cacciaguerra L, Abdel-Mannan O, Champsas D, Mankad K, Krecke KN, Chen JJ, Syc-Mazurek SB, Redenbaugh V, Lopez-Chiriboga AS, Valencia-Sanchez C, Hemingway C, Tillema JM, Ciccarelli O, Pittock SJ, Hacohen Y, Flanagan EP. Radiologic Lag and Brain MRI Lesion Dynamics During Attacks in MOG Antibody-Associated Disease. Neurology 2024; 102:e209303. [PMID: 38710000 DOI: 10.1212/wnl.0000000000209303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Knowledge of the evolution of CNS demyelinating lesions within attacks could assist diagnosis. We evaluated intra-attack lesion dynamics in patients with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) vs multiple sclerosis (MS) and aquaporin-4 antibody seropositive neuromyelitis optica spectrum disorder (AQP4+NMOSD). METHODS This retrospective observational multicenter study included consecutive patients from Mayo Clinic (USA) and Great Ormond Street Hospital for Children (UK). Inclusion criteria were as follows: (1) MOGAD, MS, or AQP4+NMOSD diagnosis; (2) availability of ≥2 brain MRIs (within 30 days of attack onset); and (3) brain involvement (i.e., ≥1 T2 lesion) on ≥1 brain MRI. The initial and subsequent brain MRIs within a single attack were evaluated for the following: new T2 lesions(s); resolved T2 lesion(s); both; or no change. This was compared between MOGAD, MS, and AQP4+NMOSD attacks. We used the Mann-Whitney U test and χ2/Fisher exact test for statistical analysis. RESULTS Our cohort included 55 patients with MOGAD (median age, 14 years; interquartile range [IQR] 5-34; female sex, 29 [53%]) for a total of 58 attacks. The comparison groups included 38 patients with MS, and 19 with AQP4+NMOSD. In MOGAD, the initial brain MRI (median of 5 days from onset [IQR 3-9]) was normal in 6/58 (10%) attacks despite cerebral symptoms (i.e., radiologic lag). The commonest reason for repeat MRI was clinical worsening or no improvement (33/56 [59%] attacks with details available). When compared with the first MRI, the second intra-attack MRI (median of 8 days from initial scan [IQR 5-13]) showed the following: new T2 lesion(s) 27/58 (47%); stability 24/58 (41%); resolution of T2 lesion(s) 4/58 (7%); or both new and resolved T2 lesions 3/58 (5%). Findings were similar between children and adults. Steroid treatment was associated with resolution of ≥1 T2 lesion (6/28 [21%] vs 1/30 [3%], p = 0.048) and reduced the likelihood of new T2 lesions (9/28 vs 18/30, p = 0.03). Intra-attack MRI changes favored MOGAD (34/58 [59%]) over MS (10/38 [26%], p = 0.002) and AQP4+NMOSD (4/19 [21%], p = 0.007). Resolution of ≥1 T2 lesions was exclusive to MOGAD (7/58 [12%]). DISCUSSION Radiologic lag is common within MOGAD attacks. Dynamic imaging with frequent appearance and occasional disappearance of lesions within a single attack suggest MOGAD diagnosis over MS and AQP4+NMOSD. These findings have implications for clinical practice, clinical trial attack adjudication, and understanding of MOGAD pathogenesis.
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Affiliation(s)
- Laura Cacciaguerra
- From the Department of Neurology and Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology (L.C., J.J.C., S.B.S.-M., V.R., J.-M.T., S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Queen Square MS Centre (O.A.-M., D.C., C.H., O.C., Y.H.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; Department of Neurology (O.A.-M., D.C., C.H., Y.H.), and Department of Neuroradiology (K.M.), Great Ormond Street Hospital for Children, London, United Kingdom; Department of Radiology (K.N.K.), Department of Ophthalmology (J.J.C.), and Laboratory Medicine and Pathology (S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Department of Neurology (A.S.L.-C.), Mayo Clinic, Jacksonville, FL; Department of Neurology (C.V.-S.), Mayo Clinic, Phoenix, AZ; and NIHR University College London Hospitals Biomedical Research Centre (O.C.), United Kingdom
| | - Omar Abdel-Mannan
- From the Department of Neurology and Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology (L.C., J.J.C., S.B.S.-M., V.R., J.-M.T., S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Queen Square MS Centre (O.A.-M., D.C., C.H., O.C., Y.H.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; Department of Neurology (O.A.-M., D.C., C.H., Y.H.), and Department of Neuroradiology (K.M.), Great Ormond Street Hospital for Children, London, United Kingdom; Department of Radiology (K.N.K.), Department of Ophthalmology (J.J.C.), and Laboratory Medicine and Pathology (S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Department of Neurology (A.S.L.-C.), Mayo Clinic, Jacksonville, FL; Department of Neurology (C.V.-S.), Mayo Clinic, Phoenix, AZ; and NIHR University College London Hospitals Biomedical Research Centre (O.C.), United Kingdom
| | - Dimitrios Champsas
- From the Department of Neurology and Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology (L.C., J.J.C., S.B.S.-M., V.R., J.-M.T., S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Queen Square MS Centre (O.A.-M., D.C., C.H., O.C., Y.H.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; Department of Neurology (O.A.-M., D.C., C.H., Y.H.), and Department of Neuroradiology (K.M.), Great Ormond Street Hospital for Children, London, United Kingdom; Department of Radiology (K.N.K.), Department of Ophthalmology (J.J.C.), and Laboratory Medicine and Pathology (S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Department of Neurology (A.S.L.-C.), Mayo Clinic, Jacksonville, FL; Department of Neurology (C.V.-S.), Mayo Clinic, Phoenix, AZ; and NIHR University College London Hospitals Biomedical Research Centre (O.C.), United Kingdom
| | - Kshitij Mankad
- From the Department of Neurology and Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology (L.C., J.J.C., S.B.S.-M., V.R., J.-M.T., S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Queen Square MS Centre (O.A.-M., D.C., C.H., O.C., Y.H.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; Department of Neurology (O.A.-M., D.C., C.H., Y.H.), and Department of Neuroradiology (K.M.), Great Ormond Street Hospital for Children, London, United Kingdom; Department of Radiology (K.N.K.), Department of Ophthalmology (J.J.C.), and Laboratory Medicine and Pathology (S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Department of Neurology (A.S.L.-C.), Mayo Clinic, Jacksonville, FL; Department of Neurology (C.V.-S.), Mayo Clinic, Phoenix, AZ; and NIHR University College London Hospitals Biomedical Research Centre (O.C.), United Kingdom
| | - Karl N Krecke
- From the Department of Neurology and Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology (L.C., J.J.C., S.B.S.-M., V.R., J.-M.T., S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Queen Square MS Centre (O.A.-M., D.C., C.H., O.C., Y.H.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; Department of Neurology (O.A.-M., D.C., C.H., Y.H.), and Department of Neuroradiology (K.M.), Great Ormond Street Hospital for Children, London, United Kingdom; Department of Radiology (K.N.K.), Department of Ophthalmology (J.J.C.), and Laboratory Medicine and Pathology (S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Department of Neurology (A.S.L.-C.), Mayo Clinic, Jacksonville, FL; Department of Neurology (C.V.-S.), Mayo Clinic, Phoenix, AZ; and NIHR University College London Hospitals Biomedical Research Centre (O.C.), United Kingdom
| | - John J Chen
- From the Department of Neurology and Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology (L.C., J.J.C., S.B.S.-M., V.R., J.-M.T., S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Queen Square MS Centre (O.A.-M., D.C., C.H., O.C., Y.H.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; Department of Neurology (O.A.-M., D.C., C.H., Y.H.), and Department of Neuroradiology (K.M.), Great Ormond Street Hospital for Children, London, United Kingdom; Department of Radiology (K.N.K.), Department of Ophthalmology (J.J.C.), and Laboratory Medicine and Pathology (S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Department of Neurology (A.S.L.-C.), Mayo Clinic, Jacksonville, FL; Department of Neurology (C.V.-S.), Mayo Clinic, Phoenix, AZ; and NIHR University College London Hospitals Biomedical Research Centre (O.C.), United Kingdom
| | - Stephanie B Syc-Mazurek
- From the Department of Neurology and Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology (L.C., J.J.C., S.B.S.-M., V.R., J.-M.T., S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Queen Square MS Centre (O.A.-M., D.C., C.H., O.C., Y.H.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; Department of Neurology (O.A.-M., D.C., C.H., Y.H.), and Department of Neuroradiology (K.M.), Great Ormond Street Hospital for Children, London, United Kingdom; Department of Radiology (K.N.K.), Department of Ophthalmology (J.J.C.), and Laboratory Medicine and Pathology (S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Department of Neurology (A.S.L.-C.), Mayo Clinic, Jacksonville, FL; Department of Neurology (C.V.-S.), Mayo Clinic, Phoenix, AZ; and NIHR University College London Hospitals Biomedical Research Centre (O.C.), United Kingdom
| | - Vyanka Redenbaugh
- From the Department of Neurology and Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology (L.C., J.J.C., S.B.S.-M., V.R., J.-M.T., S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Queen Square MS Centre (O.A.-M., D.C., C.H., O.C., Y.H.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; Department of Neurology (O.A.-M., D.C., C.H., Y.H.), and Department of Neuroradiology (K.M.), Great Ormond Street Hospital for Children, London, United Kingdom; Department of Radiology (K.N.K.), Department of Ophthalmology (J.J.C.), and Laboratory Medicine and Pathology (S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Department of Neurology (A.S.L.-C.), Mayo Clinic, Jacksonville, FL; Department of Neurology (C.V.-S.), Mayo Clinic, Phoenix, AZ; and NIHR University College London Hospitals Biomedical Research Centre (O.C.), United Kingdom
| | - Alfonso S Lopez-Chiriboga
- From the Department of Neurology and Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology (L.C., J.J.C., S.B.S.-M., V.R., J.-M.T., S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Queen Square MS Centre (O.A.-M., D.C., C.H., O.C., Y.H.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; Department of Neurology (O.A.-M., D.C., C.H., Y.H.), and Department of Neuroradiology (K.M.), Great Ormond Street Hospital for Children, London, United Kingdom; Department of Radiology (K.N.K.), Department of Ophthalmology (J.J.C.), and Laboratory Medicine and Pathology (S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Department of Neurology (A.S.L.-C.), Mayo Clinic, Jacksonville, FL; Department of Neurology (C.V.-S.), Mayo Clinic, Phoenix, AZ; and NIHR University College London Hospitals Biomedical Research Centre (O.C.), United Kingdom
| | - Cristina Valencia-Sanchez
- From the Department of Neurology and Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology (L.C., J.J.C., S.B.S.-M., V.R., J.-M.T., S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Queen Square MS Centre (O.A.-M., D.C., C.H., O.C., Y.H.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; Department of Neurology (O.A.-M., D.C., C.H., Y.H.), and Department of Neuroradiology (K.M.), Great Ormond Street Hospital for Children, London, United Kingdom; Department of Radiology (K.N.K.), Department of Ophthalmology (J.J.C.), and Laboratory Medicine and Pathology (S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Department of Neurology (A.S.L.-C.), Mayo Clinic, Jacksonville, FL; Department of Neurology (C.V.-S.), Mayo Clinic, Phoenix, AZ; and NIHR University College London Hospitals Biomedical Research Centre (O.C.), United Kingdom
| | - Cheryl Hemingway
- From the Department of Neurology and Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology (L.C., J.J.C., S.B.S.-M., V.R., J.-M.T., S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Queen Square MS Centre (O.A.-M., D.C., C.H., O.C., Y.H.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; Department of Neurology (O.A.-M., D.C., C.H., Y.H.), and Department of Neuroradiology (K.M.), Great Ormond Street Hospital for Children, London, United Kingdom; Department of Radiology (K.N.K.), Department of Ophthalmology (J.J.C.), and Laboratory Medicine and Pathology (S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Department of Neurology (A.S.L.-C.), Mayo Clinic, Jacksonville, FL; Department of Neurology (C.V.-S.), Mayo Clinic, Phoenix, AZ; and NIHR University College London Hospitals Biomedical Research Centre (O.C.), United Kingdom
| | - Jan-Mendelt Tillema
- From the Department of Neurology and Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology (L.C., J.J.C., S.B.S.-M., V.R., J.-M.T., S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Queen Square MS Centre (O.A.-M., D.C., C.H., O.C., Y.H.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; Department of Neurology (O.A.-M., D.C., C.H., Y.H.), and Department of Neuroradiology (K.M.), Great Ormond Street Hospital for Children, London, United Kingdom; Department of Radiology (K.N.K.), Department of Ophthalmology (J.J.C.), and Laboratory Medicine and Pathology (S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Department of Neurology (A.S.L.-C.), Mayo Clinic, Jacksonville, FL; Department of Neurology (C.V.-S.), Mayo Clinic, Phoenix, AZ; and NIHR University College London Hospitals Biomedical Research Centre (O.C.), United Kingdom
| | - Olga Ciccarelli
- From the Department of Neurology and Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology (L.C., J.J.C., S.B.S.-M., V.R., J.-M.T., S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Queen Square MS Centre (O.A.-M., D.C., C.H., O.C., Y.H.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; Department of Neurology (O.A.-M., D.C., C.H., Y.H.), and Department of Neuroradiology (K.M.), Great Ormond Street Hospital for Children, London, United Kingdom; Department of Radiology (K.N.K.), Department of Ophthalmology (J.J.C.), and Laboratory Medicine and Pathology (S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Department of Neurology (A.S.L.-C.), Mayo Clinic, Jacksonville, FL; Department of Neurology (C.V.-S.), Mayo Clinic, Phoenix, AZ; and NIHR University College London Hospitals Biomedical Research Centre (O.C.), United Kingdom
| | - Sean J Pittock
- From the Department of Neurology and Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology (L.C., J.J.C., S.B.S.-M., V.R., J.-M.T., S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Queen Square MS Centre (O.A.-M., D.C., C.H., O.C., Y.H.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; Department of Neurology (O.A.-M., D.C., C.H., Y.H.), and Department of Neuroradiology (K.M.), Great Ormond Street Hospital for Children, London, United Kingdom; Department of Radiology (K.N.K.), Department of Ophthalmology (J.J.C.), and Laboratory Medicine and Pathology (S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Department of Neurology (A.S.L.-C.), Mayo Clinic, Jacksonville, FL; Department of Neurology (C.V.-S.), Mayo Clinic, Phoenix, AZ; and NIHR University College London Hospitals Biomedical Research Centre (O.C.), United Kingdom
| | - Yael Hacohen
- From the Department of Neurology and Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology (L.C., J.J.C., S.B.S.-M., V.R., J.-M.T., S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Queen Square MS Centre (O.A.-M., D.C., C.H., O.C., Y.H.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; Department of Neurology (O.A.-M., D.C., C.H., Y.H.), and Department of Neuroradiology (K.M.), Great Ormond Street Hospital for Children, London, United Kingdom; Department of Radiology (K.N.K.), Department of Ophthalmology (J.J.C.), and Laboratory Medicine and Pathology (S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Department of Neurology (A.S.L.-C.), Mayo Clinic, Jacksonville, FL; Department of Neurology (C.V.-S.), Mayo Clinic, Phoenix, AZ; and NIHR University College London Hospitals Biomedical Research Centre (O.C.), United Kingdom
| | - Eoin P Flanagan
- From the Department of Neurology and Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology (L.C., J.J.C., S.B.S.-M., V.R., J.-M.T., S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Queen Square MS Centre (O.A.-M., D.C., C.H., O.C., Y.H.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; Department of Neurology (O.A.-M., D.C., C.H., Y.H.), and Department of Neuroradiology (K.M.), Great Ormond Street Hospital for Children, London, United Kingdom; Department of Radiology (K.N.K.), Department of Ophthalmology (J.J.C.), and Laboratory Medicine and Pathology (S.J.P., E.P.F.), Mayo Clinic, Rochester, MN; Department of Neurology (A.S.L.-C.), Mayo Clinic, Jacksonville, FL; Department of Neurology (C.V.-S.), Mayo Clinic, Phoenix, AZ; and NIHR University College London Hospitals Biomedical Research Centre (O.C.), United Kingdom
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Jeyakumar N, Lerch M, Dale RC, Ramanathan S. MOG antibody-associated optic neuritis. Eye (Lond) 2024:10.1038/s41433-024-03108-y. [PMID: 38783085 DOI: 10.1038/s41433-024-03108-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/04/2024] [Accepted: 04/19/2024] [Indexed: 05/25/2024] Open
Abstract
Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is a demyelinating disorder, distinct from multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). MOGAD most frequently presents with optic neuritis (MOG-ON), often with characteristic clinical and radiological features. Bilateral involvement, disc swelling clinically and radiologically, and longitudinally extensive optic nerve hyperintensity with associated optic perineuritis on MRI are key characteristics that can help distinguish MOG-ON from optic neuritis due to other aetiologies. The detection of serum MOG immunoglobulin G utilising a live cell-based assay in a patient with a compatible clinical phenotype is highly specific for the diagnosis of MOGAD. This review will highlight the key clinical and radiological features which expedite diagnosis, as well as ancillary investigations such as visual fields, visual evoked potentials and cerebrospinal fluid analysis, which may be less discriminatory. Optical coherence tomography can identify optic nerve swelling acutely, and atrophy chronically, and may transpire to have utility as a diagnostic and prognostic biomarker. MOG-ON appears to be largely responsive to corticosteroids, which are often the mainstay of acute management. However, relapses are common in patients in whom follow-up is prolonged, often in the context of early or rapid corticosteroid tapering. Establishing optimal acute therapy, the role of maintenance steroid-sparing immunotherapy for long-term relapse prevention, and identifying predictors of relapsing disease remain key research priorities in MOG-ON.
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Affiliation(s)
- Niroshan Jeyakumar
- Translational Neuroimmunology Group, Kids Neuroscience Centre and Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Department of Neurology, Westmead Hospital, Sydney, NSW, Australia
| | - Magdalena Lerch
- Translational Neuroimmunology Group, Kids Neuroscience Centre and Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Russell C Dale
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Clinical Neuroimmunology Group, Kids Neuroscience Centre and Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- TY Nelson Department of Neurology, Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Sudarshini Ramanathan
- Translational Neuroimmunology Group, Kids Neuroscience Centre and Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
- Department of Neurology, Concord Hospital, Sydney, NSW, Australia.
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5
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Trivedi RR, Archambault AS, Pavlak C, Gastaldi M, Cantoni C, Ghezzi L, Cross AH, Miller TM, Wu GF. Prevalence of anti-myelin oligodendrocyte glycoprotein antibodies across neuroinflammatory and neurodegenerative diseases. J Neurol Sci 2024; 461:123041. [PMID: 38744216 DOI: 10.1016/j.jns.2024.123041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 04/14/2024] [Accepted: 05/07/2024] [Indexed: 05/16/2024]
Abstract
Inflammatory central nervous system (CNS) diseases, such as multiple sclerosis (MS) and myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD), are characterized by humoral immune abnormalities. Anti-MOG antibodies are not specific to MOGAD, with their presence described in MS. Autoantibodies may also be present and play a role in various neurodegenerative diseases. Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease driven by motor neuron dysfunction. While immune involvement in ALS has been recognized, the presence of antibodies targeting CNS myelin antigens has not been established. We aimed to establish a live cell-based assay for quantification of serum anti-MOG IgG1 in patients with CNS diseases, including MS and ALS. In total, 771 serum samples from the John L. Trotter MS Center and the Northeast ALS Consortium were examined using a live cell-based assay for detection of anti-MOG IgG1. Samples from three cohorts were tested in blinded fashion: healthy control (HC) subjects, patients with clinically diagnosed MOGAD, and an experimental group of ALS and MS patients. All samples from established MOGAD cases were positive for anti-MOG antibodies, while all HC samples were negative. Anti-MOG IgG1 was detected in 65 of 658 samples (9.9%) from MS subjects and 4 of 108 (3.7%) samples from ALS subjects. The presence of serum anti-MOG IgG1 in MS and ALS patients raises questions about the contribution of these antibodies to disease pathophysiology as well as accuracy of diagnostic approaches for CNS inflammatory diseases.
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Affiliation(s)
- Ritu R Trivedi
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, United States of America
| | - Angela S Archambault
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, United States of America
| | - Clarice Pavlak
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, United States of America
| | - Matteo Gastaldi
- Fondazione "Istituto Neurologico Casimiro Mondino" Pavia, 27100, Italy
| | - Claudia Cantoni
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, United States of America
| | - Laura Ghezzi
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, United States of America
| | - Anne H Cross
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, United States of America
| | - Timothy M Miller
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, United States of America
| | - Gregory F Wu
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, United States of America; Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO 63110, United States of America; Neurology service, Veterans Affairs Saint Louis Health Care System, Saint Louis, MO 63106, United States of America.
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6
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Burton JM, Youn S, Al-Ani A, Costello F. Patterns and utility of myelin oligodendrocyte glycoprotein (MOG) antibody testing in cerebrospinal fluid. J Neurol 2024; 271:2662-2671. [PMID: 38366070 DOI: 10.1007/s00415-024-12213-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/20/2024] [Accepted: 01/22/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is an idiopathic central nervous system (CNS) demyelinating disease gaining recognition with wider availability of cell-based assay (CBA) testing and recently published diagnostic criteria. However, uncertainty remains regarding the interpretation of antibody titers, particularly cerebrospinal fluid (CSF) MOG antibody titers. METHODS All MOG IgG CBA results performed by the provincial MitogenDx laboratory in Alberta from July 2017 to July 2023 were retrieved. Chart review was performed in patients with both serum and CSF testing and ≥ 1 positive MOG antibody result. Demographics, antibody titers, clinical and imaging features, treatment, and diagnosis were analyzed based on serum/CSF status. RESULTS Among 4494 MOG CBA assays, there were 413 CSF samples in 402 patients, and 268 patients had at least one associated serum sample. Mean time between CSF and serum testing was 20.9 days (range 0-870 days), most with testing within 30 days. Five of the 268 patients had serum positive/CSF positive MOG antibodies, 4 with acute disseminated encephalomyelitis and 1 with longitudinally extensive transverse myelitis. Twenty-three patients had serum positive/CSF negative MOG and 13/23 with optic neuritis. CSF MOG antibody positive patients were younger, and more likely to remain MOG seropositive versus CSF negative patients. No seronegative patient had MOG antibodies in CSF. CONCLUSIONS In province-wide testing, CSF MOG antibodies were rare, only in MOG seropositive patients and none with optic neuritis. Our study does not support a clear role for CSF MOG antibody testing in the majority of patients, although further study is required.
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MESH Headings
- Humans
- Myelin-Oligodendrocyte Glycoprotein/immunology
- Male
- Female
- Adult
- Middle Aged
- Autoantibodies/cerebrospinal fluid
- Autoantibodies/blood
- Aged
- Adolescent
- Young Adult
- Child
- Aged, 80 and over
- Child, Preschool
- Demyelinating Autoimmune Diseases, CNS/cerebrospinal fluid
- Demyelinating Autoimmune Diseases, CNS/immunology
- Demyelinating Autoimmune Diseases, CNS/diagnosis
- Demyelinating Autoimmune Diseases, CNS/blood
- Encephalomyelitis, Acute Disseminated/diagnosis
- Encephalomyelitis, Acute Disseminated/cerebrospinal fluid
- Encephalomyelitis, Acute Disseminated/immunology
- Encephalomyelitis, Acute Disseminated/blood
- Retrospective Studies
- Optic Neuritis/cerebrospinal fluid
- Optic Neuritis/immunology
- Optic Neuritis/diagnosis
- Optic Neuritis/blood
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Affiliation(s)
- Jodie M Burton
- Division of Neurology, Department of Clinical Neurosciences, University of Calgary, Cumming School of Medicine, Health Sciences Centre, Room 1007C, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada.
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
| | - Saerom Youn
- Department of Surgery (Ophthalmology), University of Calgary, Cumming School of Medicine, Calgary, AB, Canada
| | - Abdullah Al-Ani
- Department of Surgery (Ophthalmology), University of Calgary, Cumming School of Medicine, Calgary, AB, Canada
| | - Fiona Costello
- Division of Neurology, Department of Clinical Neurosciences, University of Calgary, Cumming School of Medicine, Health Sciences Centre, Room 1007C, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Surgery (Ophthalmology), University of Calgary, Cumming School of Medicine, Calgary, AB, Canada
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7
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Redenbaugh V, Fryer JP, Cacciaguerra L, Chen JJ, Greenwood TM, Gilligan M, Thakolwiboon S, Majed M, Chia NH, McKeon A, Mills JR, Lopez Chiriboga AS, Tillema JM, Yang B, Abdulrahman Y, Guo K, Vorasoot N, Valencia Sanchez C, Tajfirouz DA, Toledano M, Zekeridou A, Dubey D, Gombolay GY, Caparó-Zamalloa C, Kister I, Pittock SJ, Flanagan EP. Diagnostic Utility of MOG Antibody Testing in Cerebrospinal Fluid. Ann Neurol 2024. [PMID: 38591875 DOI: 10.1002/ana.26931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 03/09/2024] [Accepted: 03/15/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVE The aim of this study was to assess the diagnostic utility of cerebrospinal fluid (CSF) myelin oligodendrocyte glycoprotein antibodies (MOG-IgG) testing. METHODS We retrospectively identified patients for CSF MOG-IgG testing from January 1, 1996, to May 1, 2023, at Mayo Clinic and other medical centers that sent CSF MOG-IgG for testing including: controls, 282; serum MOG-IgG positive MOG antibody-associated disease (MOGAD), 74; serum MOG-IgG negative high-risk phenotypes, 73; serum false positive MOG-IgG with alternative diagnoses, 18. A live cell-based assay assessed CSF MOG-IgG positivity (IgG-binding-index [IBI], ≥2.5) using multiple anti-human secondary antibodies and end-titers were calculated if sufficient sample volume. Correlation of CSF MOG-IgG IBI and titer was assessed. RESULTS The pan-IgG Fc-specific secondary was optimal, yielding CSF MOG-IgG sensitivity of 90% and specificity of 98% (Youden's index 0.88). CSF MOG-IgG was positive in: 4/282 (1.4%) controls; 66/74 (89%) serum MOG-IgG positive MOGAD patients; and 9/73 (12%) serum MOG-IgG negative patients with high-risk phenotypes. Serum negative but CSF positive MOG-IgG accounted for 9/83 (11%) MOGAD patients, and all fulfilled 2023 MOGAD diagnostic criteria. Subgroup analysis of serum MOG-IgG low-positives revealed CSF MOG-IgG positivity more in MOGAD (13/16[81%]) than other diseases with false positive serum MOG-IgG (3/15[20%]) (p = 0.01). CSF MOG-IgG IBI and CSF MOG-IgG titer (both available in 29 samples) were correlated (Spearman's r = 0.64, p < 0.001). INTERPRETATION CSF MOG-IgG testing has diagnostic utility in patients with a suspicious phenotype but negative serum MOG-IgG, and those with low positive serum MOG-IgG results and diagnostic uncertainty. These findings support a role for CSF MOG-IgG testing in the appropriate clinical setting. ANN NEUROL 2024.
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Affiliation(s)
- Vyanka Redenbaugh
- Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - James P Fryer
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Laura Cacciaguerra
- Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - John J Chen
- Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
- Ophthalmology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Tammy M Greenwood
- Ophthalmology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Michael Gilligan
- Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
- Department of Neurology, St Vincent's University Hospital, Dublin, Ireland
| | - Smathorn Thakolwiboon
- Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Masoud Majed
- Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Nicholas H Chia
- Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Andrew McKeon
- Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - John R Mills
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | | | - Jan-Mendelt Tillema
- Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Binxia Yang
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Yahya Abdulrahman
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Kai Guo
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Nisa Vorasoot
- Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
- Division of Neurology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | - Deena A Tajfirouz
- Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
- Ophthalmology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Michel Toledano
- Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Anastasia Zekeridou
- Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Divyanshu Dubey
- Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Grace Y Gombolay
- Emory University, Children's Healthcare of Atlanta: Pediatrics Institute, Atlanta, Georgia, USA
| | - César Caparó-Zamalloa
- Basic Research Center in Dementia and Central Nervous System Demyelinating Diseases, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - Ilya Kister
- Department of Neurology, Comprehensive MS Center, NYU Grossman School of Medicine, New York, New York, USA
| | - Sean J Pittock
- Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Eoin P Flanagan
- Department of Neurology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
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8
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Olivé-Cirera G, Bruijstens AL, Fonseca EG, Chen LW, Caballero E, Martinez-Hernandez E, Guasp M, Sepúlveda M, Naranjo L, Ruiz-García R, Blanco Y, Saiz A, Dalmau JO, Armangue T. MOG Antibodies Restricted to CSF in Children With Inflammatory CNS Disorders. Neurology 2024; 102:e209199. [PMID: 38447115 DOI: 10.1212/wnl.0000000000209199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/13/2023] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVES To assess the clinical significance of myelin oligodendrocyte glycoprotein antibodies (MOG-abs) restricted to CSF in children with inflammatory CNS disorders. METHODS Patients included 760 children (younger than 18 years) from 3 multicenter prospective cohort studies: (A) acquired demyelinating syndromes, including acute disseminated encephalomyelitis (ADEM); (B) non-ADEM encephalitis; and (C) noninflammatory neurologic disorders. For all cases, paired serum/CSF samples were systematically examined using brain immunohistochemistry and live cell-based assays. RESULTS A total of 109 patients (14%) had MOG-abs in serum or CSF: 79 from cohort A, 30 from B, and none from C. Of these, 63 (58%) had antibodies in both samples, 37 (34%) only in serum, and 9 (8%) only in CSF. Children with MOG-abs only in CSF were older than those with MOG-abs only in serum or in both samples (median 12 vs 6 vs 5 years, p = 0.0002) and were more likely to have CSF oligoclonal bands (86% vs 12% vs 7%, p = 0.0001) and be diagnosed with multiple sclerosis (6/9 [67%] vs 0/37 [0%] vs 1/63 [2%], p < 0.0001). DISCUSSION Detection of MOG-abs in serum or CSF is associated with CNS inflammatory disorders. Children with MOG-abs restricted to CSF are more likely to have CSF oligoclonal bands and multiple sclerosis than those with MOG-abs detectable in serum.
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Affiliation(s)
- Gemma Olivé-Cirera
- From the Neuroimmunology Program (G.O.-C., A.L.B., E.G.F., L.-W.C., E.C., E.M.-H., M.G., M.P., R.R.G., Y.B., A.S., J.O.D., T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona; Pediatric Neurology Department (G.O.-C.), Hospital Parc Taulí de Sabadell, Spain; Department of Neurology (A.L.B.), Erasmus Medical Center, Rotterdam, the Netherlands; Department of Pediatrics (L.-W.C.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Neurology Department (E.M.-H., M.G., M.P., Y.B., A.S., J.O.D.), Institute of Neuroscience, Hospital Clínic, University of Barcelona; Centro de Investigación Biomédica en Red (E.M.-H., M.G., M.P., Y.B., J.O.D.), Enfermedades Raras (CIBERER); Department of Immunology (L.N., R.R.G.), Centre Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain; Department of Neurology (J.O.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Catalan Institute for Research and Advanced Studies (ICREA) (J.O.D.); and Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, ERN-RITA accredited center, University of Barcelona, Spain
| | - Arlette L Bruijstens
- From the Neuroimmunology Program (G.O.-C., A.L.B., E.G.F., L.-W.C., E.C., E.M.-H., M.G., M.P., R.R.G., Y.B., A.S., J.O.D., T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona; Pediatric Neurology Department (G.O.-C.), Hospital Parc Taulí de Sabadell, Spain; Department of Neurology (A.L.B.), Erasmus Medical Center, Rotterdam, the Netherlands; Department of Pediatrics (L.-W.C.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Neurology Department (E.M.-H., M.G., M.P., Y.B., A.S., J.O.D.), Institute of Neuroscience, Hospital Clínic, University of Barcelona; Centro de Investigación Biomédica en Red (E.M.-H., M.G., M.P., Y.B., J.O.D.), Enfermedades Raras (CIBERER); Department of Immunology (L.N., R.R.G.), Centre Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain; Department of Neurology (J.O.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Catalan Institute for Research and Advanced Studies (ICREA) (J.O.D.); and Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, ERN-RITA accredited center, University of Barcelona, Spain
| | - Elianet G Fonseca
- From the Neuroimmunology Program (G.O.-C., A.L.B., E.G.F., L.-W.C., E.C., E.M.-H., M.G., M.P., R.R.G., Y.B., A.S., J.O.D., T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona; Pediatric Neurology Department (G.O.-C.), Hospital Parc Taulí de Sabadell, Spain; Department of Neurology (A.L.B.), Erasmus Medical Center, Rotterdam, the Netherlands; Department of Pediatrics (L.-W.C.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Neurology Department (E.M.-H., M.G., M.P., Y.B., A.S., J.O.D.), Institute of Neuroscience, Hospital Clínic, University of Barcelona; Centro de Investigación Biomédica en Red (E.M.-H., M.G., M.P., Y.B., J.O.D.), Enfermedades Raras (CIBERER); Department of Immunology (L.N., R.R.G.), Centre Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain; Department of Neurology (J.O.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Catalan Institute for Research and Advanced Studies (ICREA) (J.O.D.); and Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, ERN-RITA accredited center, University of Barcelona, Spain
| | - Li-Wen Chen
- From the Neuroimmunology Program (G.O.-C., A.L.B., E.G.F., L.-W.C., E.C., E.M.-H., M.G., M.P., R.R.G., Y.B., A.S., J.O.D., T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona; Pediatric Neurology Department (G.O.-C.), Hospital Parc Taulí de Sabadell, Spain; Department of Neurology (A.L.B.), Erasmus Medical Center, Rotterdam, the Netherlands; Department of Pediatrics (L.-W.C.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Neurology Department (E.M.-H., M.G., M.P., Y.B., A.S., J.O.D.), Institute of Neuroscience, Hospital Clínic, University of Barcelona; Centro de Investigación Biomédica en Red (E.M.-H., M.G., M.P., Y.B., J.O.D.), Enfermedades Raras (CIBERER); Department of Immunology (L.N., R.R.G.), Centre Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain; Department of Neurology (J.O.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Catalan Institute for Research and Advanced Studies (ICREA) (J.O.D.); and Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, ERN-RITA accredited center, University of Barcelona, Spain
| | - Eva Caballero
- From the Neuroimmunology Program (G.O.-C., A.L.B., E.G.F., L.-W.C., E.C., E.M.-H., M.G., M.P., R.R.G., Y.B., A.S., J.O.D., T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona; Pediatric Neurology Department (G.O.-C.), Hospital Parc Taulí de Sabadell, Spain; Department of Neurology (A.L.B.), Erasmus Medical Center, Rotterdam, the Netherlands; Department of Pediatrics (L.-W.C.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Neurology Department (E.M.-H., M.G., M.P., Y.B., A.S., J.O.D.), Institute of Neuroscience, Hospital Clínic, University of Barcelona; Centro de Investigación Biomédica en Red (E.M.-H., M.G., M.P., Y.B., J.O.D.), Enfermedades Raras (CIBERER); Department of Immunology (L.N., R.R.G.), Centre Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain; Department of Neurology (J.O.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Catalan Institute for Research and Advanced Studies (ICREA) (J.O.D.); and Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, ERN-RITA accredited center, University of Barcelona, Spain
| | - Eugenia Martinez-Hernandez
- From the Neuroimmunology Program (G.O.-C., A.L.B., E.G.F., L.-W.C., E.C., E.M.-H., M.G., M.P., R.R.G., Y.B., A.S., J.O.D., T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona; Pediatric Neurology Department (G.O.-C.), Hospital Parc Taulí de Sabadell, Spain; Department of Neurology (A.L.B.), Erasmus Medical Center, Rotterdam, the Netherlands; Department of Pediatrics (L.-W.C.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Neurology Department (E.M.-H., M.G., M.P., Y.B., A.S., J.O.D.), Institute of Neuroscience, Hospital Clínic, University of Barcelona; Centro de Investigación Biomédica en Red (E.M.-H., M.G., M.P., Y.B., J.O.D.), Enfermedades Raras (CIBERER); Department of Immunology (L.N., R.R.G.), Centre Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain; Department of Neurology (J.O.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Catalan Institute for Research and Advanced Studies (ICREA) (J.O.D.); and Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, ERN-RITA accredited center, University of Barcelona, Spain
| | - Mar Guasp
- From the Neuroimmunology Program (G.O.-C., A.L.B., E.G.F., L.-W.C., E.C., E.M.-H., M.G., M.P., R.R.G., Y.B., A.S., J.O.D., T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona; Pediatric Neurology Department (G.O.-C.), Hospital Parc Taulí de Sabadell, Spain; Department of Neurology (A.L.B.), Erasmus Medical Center, Rotterdam, the Netherlands; Department of Pediatrics (L.-W.C.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Neurology Department (E.M.-H., M.G., M.P., Y.B., A.S., J.O.D.), Institute of Neuroscience, Hospital Clínic, University of Barcelona; Centro de Investigación Biomédica en Red (E.M.-H., M.G., M.P., Y.B., J.O.D.), Enfermedades Raras (CIBERER); Department of Immunology (L.N., R.R.G.), Centre Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain; Department of Neurology (J.O.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Catalan Institute for Research and Advanced Studies (ICREA) (J.O.D.); and Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, ERN-RITA accredited center, University of Barcelona, Spain
| | - Maria Sepúlveda
- From the Neuroimmunology Program (G.O.-C., A.L.B., E.G.F., L.-W.C., E.C., E.M.-H., M.G., M.P., R.R.G., Y.B., A.S., J.O.D., T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona; Pediatric Neurology Department (G.O.-C.), Hospital Parc Taulí de Sabadell, Spain; Department of Neurology (A.L.B.), Erasmus Medical Center, Rotterdam, the Netherlands; Department of Pediatrics (L.-W.C.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Neurology Department (E.M.-H., M.G., M.P., Y.B., A.S., J.O.D.), Institute of Neuroscience, Hospital Clínic, University of Barcelona; Centro de Investigación Biomédica en Red (E.M.-H., M.G., M.P., Y.B., J.O.D.), Enfermedades Raras (CIBERER); Department of Immunology (L.N., R.R.G.), Centre Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain; Department of Neurology (J.O.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Catalan Institute for Research and Advanced Studies (ICREA) (J.O.D.); and Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, ERN-RITA accredited center, University of Barcelona, Spain
| | - Laura Naranjo
- From the Neuroimmunology Program (G.O.-C., A.L.B., E.G.F., L.-W.C., E.C., E.M.-H., M.G., M.P., R.R.G., Y.B., A.S., J.O.D., T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona; Pediatric Neurology Department (G.O.-C.), Hospital Parc Taulí de Sabadell, Spain; Department of Neurology (A.L.B.), Erasmus Medical Center, Rotterdam, the Netherlands; Department of Pediatrics (L.-W.C.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Neurology Department (E.M.-H., M.G., M.P., Y.B., A.S., J.O.D.), Institute of Neuroscience, Hospital Clínic, University of Barcelona; Centro de Investigación Biomédica en Red (E.M.-H., M.G., M.P., Y.B., J.O.D.), Enfermedades Raras (CIBERER); Department of Immunology (L.N., R.R.G.), Centre Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain; Department of Neurology (J.O.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Catalan Institute for Research and Advanced Studies (ICREA) (J.O.D.); and Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, ERN-RITA accredited center, University of Barcelona, Spain
| | - Raquel Ruiz-García
- From the Neuroimmunology Program (G.O.-C., A.L.B., E.G.F., L.-W.C., E.C., E.M.-H., M.G., M.P., R.R.G., Y.B., A.S., J.O.D., T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona; Pediatric Neurology Department (G.O.-C.), Hospital Parc Taulí de Sabadell, Spain; Department of Neurology (A.L.B.), Erasmus Medical Center, Rotterdam, the Netherlands; Department of Pediatrics (L.-W.C.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Neurology Department (E.M.-H., M.G., M.P., Y.B., A.S., J.O.D.), Institute of Neuroscience, Hospital Clínic, University of Barcelona; Centro de Investigación Biomédica en Red (E.M.-H., M.G., M.P., Y.B., J.O.D.), Enfermedades Raras (CIBERER); Department of Immunology (L.N., R.R.G.), Centre Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain; Department of Neurology (J.O.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Catalan Institute for Research and Advanced Studies (ICREA) (J.O.D.); and Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, ERN-RITA accredited center, University of Barcelona, Spain
| | - Yolanda Blanco
- From the Neuroimmunology Program (G.O.-C., A.L.B., E.G.F., L.-W.C., E.C., E.M.-H., M.G., M.P., R.R.G., Y.B., A.S., J.O.D., T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona; Pediatric Neurology Department (G.O.-C.), Hospital Parc Taulí de Sabadell, Spain; Department of Neurology (A.L.B.), Erasmus Medical Center, Rotterdam, the Netherlands; Department of Pediatrics (L.-W.C.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Neurology Department (E.M.-H., M.G., M.P., Y.B., A.S., J.O.D.), Institute of Neuroscience, Hospital Clínic, University of Barcelona; Centro de Investigación Biomédica en Red (E.M.-H., M.G., M.P., Y.B., J.O.D.), Enfermedades Raras (CIBERER); Department of Immunology (L.N., R.R.G.), Centre Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain; Department of Neurology (J.O.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Catalan Institute for Research and Advanced Studies (ICREA) (J.O.D.); and Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, ERN-RITA accredited center, University of Barcelona, Spain
| | - Albert Saiz
- From the Neuroimmunology Program (G.O.-C., A.L.B., E.G.F., L.-W.C., E.C., E.M.-H., M.G., M.P., R.R.G., Y.B., A.S., J.O.D., T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona; Pediatric Neurology Department (G.O.-C.), Hospital Parc Taulí de Sabadell, Spain; Department of Neurology (A.L.B.), Erasmus Medical Center, Rotterdam, the Netherlands; Department of Pediatrics (L.-W.C.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Neurology Department (E.M.-H., M.G., M.P., Y.B., A.S., J.O.D.), Institute of Neuroscience, Hospital Clínic, University of Barcelona; Centro de Investigación Biomédica en Red (E.M.-H., M.G., M.P., Y.B., J.O.D.), Enfermedades Raras (CIBERER); Department of Immunology (L.N., R.R.G.), Centre Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain; Department of Neurology (J.O.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Catalan Institute for Research and Advanced Studies (ICREA) (J.O.D.); and Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, ERN-RITA accredited center, University of Barcelona, Spain
| | - Josep O Dalmau
- From the Neuroimmunology Program (G.O.-C., A.L.B., E.G.F., L.-W.C., E.C., E.M.-H., M.G., M.P., R.R.G., Y.B., A.S., J.O.D., T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona; Pediatric Neurology Department (G.O.-C.), Hospital Parc Taulí de Sabadell, Spain; Department of Neurology (A.L.B.), Erasmus Medical Center, Rotterdam, the Netherlands; Department of Pediatrics (L.-W.C.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Neurology Department (E.M.-H., M.G., M.P., Y.B., A.S., J.O.D.), Institute of Neuroscience, Hospital Clínic, University of Barcelona; Centro de Investigación Biomédica en Red (E.M.-H., M.G., M.P., Y.B., J.O.D.), Enfermedades Raras (CIBERER); Department of Immunology (L.N., R.R.G.), Centre Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain; Department of Neurology (J.O.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Catalan Institute for Research and Advanced Studies (ICREA) (J.O.D.); and Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, ERN-RITA accredited center, University of Barcelona, Spain
| | - Thaís Armangue
- From the Neuroimmunology Program (G.O.-C., A.L.B., E.G.F., L.-W.C., E.C., E.M.-H., M.G., M.P., R.R.G., Y.B., A.S., J.O.D., T.A.), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona; Pediatric Neurology Department (G.O.-C.), Hospital Parc Taulí de Sabadell, Spain; Department of Neurology (A.L.B.), Erasmus Medical Center, Rotterdam, the Netherlands; Department of Pediatrics (L.-W.C.), National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Neurology Department (E.M.-H., M.G., M.P., Y.B., A.S., J.O.D.), Institute of Neuroscience, Hospital Clínic, University of Barcelona; Centro de Investigación Biomédica en Red (E.M.-H., M.G., M.P., Y.B., J.O.D.), Enfermedades Raras (CIBERER); Department of Immunology (L.N., R.R.G.), Centre Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain; Department of Neurology (J.O.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Catalan Institute for Research and Advanced Studies (ICREA) (J.O.D.); and Pediatric Neuroimmunology Unit (T.A.), Neurology Department, Sant Joan de Déu Children's Hospital, ERN-RITA accredited center, University of Barcelona, Spain
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9
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Gilligan M, McGuigan C, McKeon A. Autoimmune central nervous system disorders: Antibody testing and its clinical utility. Clin Biochem 2024; 126:110746. [PMID: 38462203 PMCID: PMC11016295 DOI: 10.1016/j.clinbiochem.2024.110746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/16/2024] [Accepted: 03/05/2024] [Indexed: 03/12/2024]
Abstract
A rapidly expanding repertoire of neural antibody biomarkers exists for autoimmune central nervous system (CNS) disorders. Following clinical recognition of an autoimmune CNS disorder, the detection of a neural antibody facilitates diagnosis and informs prognosis and management. This review considers the phenotypes, diagnostic assay methodologies, and clinical utility of neural antibodies in autoimmune CNS disorders. Autoimmune CNS disorders may present with a diverse range of clinical features. Clinical phenotype should inform the neural antibodies selected for testing via the use of phenotype-specific panels. Both serum and cerebrospinal fluid (CSF) are preferred in the vast majority of cases but for some analytes either CSF (e.g. N-methyl-D-aspartate receptor [NMDA-R] IgG) or serum (e.g. aquaporin-4 [AQP4] IgG) specimens may be preferred. Screening using 2 methods is recommended for most analytes, particularly paraneoplastic antibodies. We utilize murine tissue-based indirect immunofluorescence assay (TIFA) with subsequent confirmatory protein-specific testing. The cellular location of the target antigen informs choice of confirmatory diagnostic assay (e.g. blot for intracellular antigens such as Hu; cell-based assay for cell surface targets such as leucine-rich glioma inactivated 1 [LGI1]). Titers of positive results have limited diagnostic utility with the exception of glutamic acid decarboxylase (GAD) 65 IgG autoimmunity, which is associated with neurological disease at higher values. While novel antibodies are typically discovered using established techniques such as TIFA and immunoprecipitation-mass spectrometry, more recent high-throughput molecular technologies (such as protein microarray and phage-display immunoprecipitation sequencing) may expedite the process of antibody discovery. Individual neural antibodies inform the clinician regarding the clinical associations, oncological risk stratification and tumor histology, the likely prognosis, and immunotherapy choice. In the era of neural antibody biomarkers for autoimmune CNS disorders, access to appropriate laboratory assays for neural antibodies is of critical importance in the diagnosis and management of these disorders.
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Affiliation(s)
- Michael Gilligan
- Departments of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA; Department of Neurology, St Vincent's University Hospital, Dublin, Ireland
| | | | - Andrew McKeon
- Departments of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA; Department of Neurology, Mayo Clinic, Rochester, MN, USA.
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10
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Schanda K, Mariotto S, Rudzki D, Bauer A, Dinoto A, Rossi P, Ferrari S, Jarius S, Wildemann B, Boso F, Giometto B, Engels D, Kümpfel T, Wendel EM, Rostasy K, Reindl M. Is there an immunological cross-reactivity of antibodies to the myelin oligodendrocyte glycoprotein and coronaviruses? Brain Commun 2024; 6:fcae106. [PMID: 38576796 PMCID: PMC10994262 DOI: 10.1093/braincomms/fcae106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/08/2024] [Accepted: 03/23/2024] [Indexed: 04/06/2024] Open
Abstract
Recent reports indicated that myelin oligodendrocyte glycoprotein antibody-associated disease might be a rare complication after severe acute respiratory syndrome coronavirus 2 infection or vaccination. It is unclear whether this is an unspecific sequel of infection or vaccination or caused by possible immunological cross-reactivity of severe acute respiratory syndrome coronavirus 2 proteins and myelin oligodendrocyte glycoprotein. The aim of this study was therefore to elucidate whether there is an immunological cross-reactivity between severe acute respiratory syndrome coronavirus 2 spike or nucleocapsid proteins and myelin oligodendrocyte glycoprotein and to explore the relation of antibody responses against myelin oligodendrocyte glycoprotein and severe acute respiratory syndrome coronavirus 2 and other coronaviruses. We analysed serum samples from patients with severe acute respiratory syndrome coronavirus 2 infection and neurological symptoms with (myelin oligodendrocyte glycoprotein antibody-associated disease, n = 12) or without myelin oligodendrocyte glycoprotein-antibodies (n = 10); severe acute respiratory syndrome coronavirus 2 infection without neurological symptoms (n = 32); vaccinated patients with no history of severe acute respiratory syndrome coronavirus 2 infection and neurological symptoms with (myelin oligodendrocyte glycoprotein antibody-associated disease, n = 10) or without myelin oligodendrocyte glycoprotein-antibodies (n = 9); and severe acute respiratory syndrome coronavirus 2 negative/naïve unvaccinated patients with neurological symptoms with (myelin oligodendrocyte glycoprotein antibody-associated disease, n = 47) or without myelin oligodendrocyte glycoprotein-antibodies (n = 20). All samples were analysed for serum antibody responses to myelin oligodendrocyte glycoprotein, severe acute respiratory syndrome coronavirus 2, and other common coronaviruses (CoV-229E, CoV-HKU1, CoV-NL63 and CoV-OC43). Based on sample amount and antibody titres, 21 samples were selected for analysis of antibody cross-reactivity between myelin oligodendrocyte glycoprotein and severe acute respiratory syndrome coronavirus 2 spike and nucleocapsid proteins using affinity purification and pre-absorption. Whereas we found no association of immunoglobulin G and A myelin oligodendrocyte glycoprotein antibodies with coronavirus antibodies, infections with severe acute respiratory syndrome coronavirus 2 correlated with an increased immunoglobulin M myelin oligodendrocyte glycoprotein antibody response. Purified antibodies showed no cross-reactivity between severe acute respiratory syndrome coronavirus 2 spike protein and myelin oligodendrocyte glycoprotein. However, one sample of a patient with myelin oligodendrocyte glycoprotein antibody-associated disease following severe acute respiratory syndrome coronavirus 2 infection showed a clear immunoglobulin G antibody cross-reactivity to severe acute respiratory syndrome coronavirus 2 nucleocapsid protein and myelin oligodendrocyte glycoprotein. This patient was also seropositive for other coronaviruses and showed immunological cross-reactivity of severe acute respiratory syndrome coronavirus 2 and CoV-229E nucleocapsid proteins. Overall, our results indicate that an immunoglobulin G antibody cross-reactivity between myelin oligodendrocyte glycoprotein and severe acute respiratory syndrome coronavirus 2 proteins is rare. The presence of increased myelin oligodendrocyte glycoprotein-immunoglobulin M antibodies after severe acute respiratory syndrome coronavirus 2 infection may either be a consequence of a previous infection with other coronaviruses or arise as an unspecific sequel after viral infection. Furthermore, our data indicate that myelin oligodendrocyte glycoprotein-immunoglobulin A and particularly myelin oligodendrocyte glycoprotein-immunoglobulin M antibodies are a rather unspecific sequel of viral infections. Finally, our findings do not support a causative role of coronavirus infections for the presence of myelin oligodendrocyte glycoprotein-immunoglobulin G antibodies.
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Affiliation(s)
- Kathrin Schanda
- Clinical Department of Neurology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Sara Mariotto
- Neurology Unit, Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, 37100 Verona, Italy
| | - Dagmar Rudzki
- Clinical Department of Neurology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Angelika Bauer
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Alessandro Dinoto
- Neurology Unit, Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, 37100 Verona, Italy
| | - Patrizia Rossi
- Neurology Unit, St Bassiano Hospital, Bassano del Grappa, 36100 Vicenza, Italy
| | - Sergio Ferrari
- Neurology Unit, Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, 37100 Verona, Italy
| | - Sven Jarius
- Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, 69120 Heidelberg, Germany
| | - Brigitte Wildemann
- Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, 69120 Heidelberg, Germany
| | - Federica Boso
- Neurology Unit, Trento Hospital, Azienda Provinciale per i Servizi Sanitari (APSS) di Trento, 38122 Trento, Italy
| | - Bruno Giometto
- Neurology Unit, Trento Hospital, Azienda Provinciale per i Servizi Sanitari (APSS) di Trento, 38122 Trento, Italy
| | - Daniel Engels
- Institute of Clinical Neuroimmunology, University Hospital, Ludwig-Maximilians-Universität München, 81375 Munich, Germany
| | - Tania Kümpfel
- Institute of Clinical Neuroimmunology, University Hospital, Ludwig-Maximilians-Universität München, 81375 Munich, Germany
| | - Eva-Maria Wendel
- Department of Neuropediatrics, Olgahospital/Klinikum Stuttgart, 70174 Stuttgart, Germany
| | - Kevin Rostasy
- Paediatric Neurology, Witten/Herdecke University, Children's Hospital Datteln, 45711 Datteln, Germany
| | - Markus Reindl
- Clinical Department of Neurology, Medical University of Innsbruck, 6020 Innsbruck, Austria
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11
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Shao W, Liu X, Li J, Sheng T, Li Y, Gu Y, Deng B, Wang J, Yang W, Yu H, Zhang X, Chen X. Characteristics of cerebrospinal fluid oligoclonal band in anti-myelin oligodendrocyte glycoprotein (MOG) antibody associated disease. Heliyon 2024; 10:e24742. [PMID: 38434296 PMCID: PMC10907529 DOI: 10.1016/j.heliyon.2024.e24742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/30/2023] [Accepted: 01/12/2024] [Indexed: 03/05/2024] Open
Abstract
Objective To analyze the immune parameters of cerebrospinal fluid (CSF) and oligoclonal band (OCB) type in patients with anti-myelin oligodendrocyte glycoprotein (MOG) antibody-associated diseases (MOGAD). Methods Patients who were seropositive for MOG-IgG and diagnosed with MOGAD according to the diagnosis criteria in the Department of Neurology, Huashan Hospital, Fudan University from December 2020 to June 2022 were retrospectively included in this study. Complete clinical data, blood and cerebrospinal fluid samples were collected from all the participants. Paired serum and CSF MOG-IgG and autoimmune encephalitis antibody were assayed by Cell Based Assay (CBA) based on transfected target antigens. Paired serum and CSF albumin and IgG were detected by turbidimetric scattering method, and OCB was detected by standard operation procedure as described. Results A total of 86 patients (44 males and 42 females) with MOGAD were included in this study, with a median age of 30 years (range: 5-82 years). Among all the patients, 73 patients showed OCB type I, 12 patients showed OCB type II, and one patient showed OCB type III. The overall positive rate of CSF-OCB in MOGAD patients was 15.1 %. The 24-h intrathecal synthesis rate of CSF in the OCB-positive group (n = 13) was higher than that in the OCB-negative group [n = 73, 0.62 (0.26) vs 5.11 (13.67), P = 0.003]. Subgroup analysis revealed that the positive rates of CSF-OCB in the single MOG group (n = 61) and the group combined with other antibodies (n = 25) were 14.8 % and 16.0 %, respectively. The incidence of meningoencephalitis (13/61 vs 13/25, P = 0.011) was significantly different between the two groups. The proportion of patients with high (≥1:32) or low (≤1:10) CSF MOG-IgG also showed significant difference in the group combined with other antibodies (P = 0.032). Optic neuritis was more common in the relapse course group (n = 49) than the monophasic course group (n = 37, P < 0.001) No significant diferences of CSF immune parameters were found in the MOG-IgGserum+/CSF- group and the MOG-IgGserum+/CSF + group, and the titer of MOG-IgG in the serum or CSF did not influence CSF immune parameters in different subgroups. Conclusion The overall positive rate of CSF-OCB in MOGAD patients was 15.1 %. The 24-h intrathecal synthesis rate of cerebrospinal fluid in the OCB-positive group was higher than that in the OCB-negative group. This study illustrated OCB characterization in MOGAD patients, and will shed light on the standardization of OCB test in the study of immune diseases.
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Affiliation(s)
- Wenjun Shao
- Department of Neurology, Huashan Hospital and Institute of Neurology, Fudan University, 12 Wulumuqi Zhong Road, Shanghai 200040, China
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, 450003, China
| | - Xiaoni Liu
- Department of Neurology, Huashan Hospital and Institute of Neurology, Fudan University, 12 Wulumuqi Zhong Road, Shanghai 200040, China
- National Center for Neurological Disorders, China
| | - Jiatong Li
- Department of Neurology, Huashan Hospital and Institute of Neurology, Fudan University, 12 Wulumuqi Zhong Road, Shanghai 200040, China
- National Center for Neurological Disorders, China
| | - Tianyang Sheng
- Department of Neurology, Huashan Hospital and Institute of Neurology, Fudan University, 12 Wulumuqi Zhong Road, Shanghai 200040, China
- National Center for Neurological Disorders, China
| | - Yarong Li
- Department of Neurology, Huashan Hospital and Institute of Neurology, Fudan University, 12 Wulumuqi Zhong Road, Shanghai 200040, China
- National Center for Neurological Disorders, China
| | - Yuehua Gu
- Department of Neurology, Huashan Hospital and Institute of Neurology, Fudan University, 12 Wulumuqi Zhong Road, Shanghai 200040, China
- National Center for Neurological Disorders, China
| | - Bo Deng
- Department of Neurology, Huashan Hospital and Institute of Neurology, Fudan University, 12 Wulumuqi Zhong Road, Shanghai 200040, China
- National Center for Neurological Disorders, China
| | - Jingguo Wang
- Department of Neurology, Huashan Hospital and Institute of Neurology, Fudan University, 12 Wulumuqi Zhong Road, Shanghai 200040, China
- National Center for Neurological Disorders, China
| | - Wenbo Yang
- Department of Neurology, Huashan Hospital and Institute of Neurology, Fudan University, 12 Wulumuqi Zhong Road, Shanghai 200040, China
- National Center for Neurological Disorders, China
| | - Hai Yu
- Department of Neurology, Huashan Hospital and Institute of Neurology, Fudan University, 12 Wulumuqi Zhong Road, Shanghai 200040, China
- National Center for Neurological Disorders, China
| | - Xiang Zhang
- Department of Neurology, Huashan Hospital and Institute of Neurology, Fudan University, 12 Wulumuqi Zhong Road, Shanghai 200040, China
- National Center for Neurological Disorders, China
| | - Xiangjun Chen
- Department of Neurology, Huashan Hospital and Institute of Neurology, Fudan University, 12 Wulumuqi Zhong Road, Shanghai 200040, China
- National Center for Neurological Disorders, China
- Human Phenome Institute, Fudan University, Shanghai, China
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12
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Kurd M, Pratt LT, Gilboa T, Fattal-Valevski A, Vaknin-Dembinsky A, Gadoth A, Hacohen Y, Meirson H. Validation of the 2023 international diagnostic criteria for MOGAD in a pediatric cohort. Eur J Paediatr Neurol 2024; 49:13-16. [PMID: 38290170 DOI: 10.1016/j.ejpn.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/10/2023] [Accepted: 01/22/2024] [Indexed: 02/01/2024]
Abstract
OBJECTIVE To validate the recently published diagnostic criteria for Myelin Oligodendrocyte Glycoprotein-antibody associated disease (MOGAD) in real-world cohort of children with acquired demyelinating syndromes. METHODS Patients <18yrs presenting with demyelinating disease to Pediatric neuroimmunology clinics at two Israeli tertiary centers who had MOG antibodies (MOG-Abs) tested between 01/07/2017 and 15/08/2023 were included. Diagnostic criteria for MOGAD were applied and sensitivity and specificities were calculated. RESULTS MOG-Abs were detected in 28/63 (44 %). Median age at onset for all patients was 11.4 yrs (range 1.1-17.6 yrs) and 41 (65 %) were female. Of the patients testing negative, ADEM was the most common diagnosis (n = 11) followed by MS (n = 8). No patients without MOG-Abs were diagnosed with MOGAD. All patients with a clinical diagnosis of MOGAD had positive MOG-Abs and fulfilled the 2023 international diagnostic criteria for MOGAD. Sensitivity, specificity, positive predictive value, and negative predictive value were 100 %. We found no difference between younger (<10yrs old) and older (>10 yrs old) children in the number of supportive criteria fulfilled at onset (median 2 vs. 2.5, p = 0.4) The number of supporting features was higher in patients with relapsing (n = 5) vs. monophasic (n = 23) disease course at onset (median 3 vs. 2, p = 0.03) and at final follow-up (median 5 vs. 2, p = 0.004). CONCLUSION Recent MOGAD diagnostic criteria had excellent performance in this pediatric cohort but did not add to the diagnostic accuracy of the antibody test alone.
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Affiliation(s)
- Mohammad Kurd
- Department of Pediatric Neurology, Hadassah University Medical Centre, Jerusalem, Israel
| | - Li-Tal Pratt
- Department of Neuroradiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tal Gilboa
- Department of Pediatric Neurology, Hadassah University Medical Centre, Jerusalem, Israel; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Aviva Fattal-Valevski
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Neurology Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Adi Vaknin-Dembinsky
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel; The Department of Neurology and Laboratory of Neuroimmunology, The Agnes-Ginges Centre for Human Neurogenetics, Hadassah-Hebrew University Medical Centre, Jerusalem, Israel
| | - Avi Gadoth
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Yael Hacohen
- Queen Square MS Centre, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Hadas Meirson
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Neurology Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
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13
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Cacciaguerra L, Flanagan EP. Updates in NMOSD and MOGAD Diagnosis and Treatment: A Tale of Two Central Nervous System Autoimmune Inflammatory Disorders. Neurol Clin 2024; 42:77-114. [PMID: 37980124 PMCID: PMC10658081 DOI: 10.1016/j.ncl.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2023]
Abstract
Aquaporin-4-IgG positive neuromyelitis optica spectrum disorder (AQP4+NMOSD) and myelin-oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are antibody-associated diseases targeting astrocytes and oligodendrocytes, respectively. Their recognition as distinct entities has led to each having its own diagnostic criteria that require a combination of clinical, serologic, and MRI features. The therapeutic approach to acute attacks in AQP4+NMOSD and MOGAD is similar. There is now class 1 evidence to support attack-prevention medications for AQP4+NMOSD. MOGAD lacks proven treatments although clinical trials are now underway. In this review, we will outline similarities and differences between AQP4+NMOSD and MOGAD in terms of diagnosis and treatment.
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Affiliation(s)
- Laura Cacciaguerra
- Department of Neurology, Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN, USA
| | - Eoin P Flanagan
- Department of Neurology, Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN, USA; Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
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14
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Carta S, Dinoto A, Capobianco M, Valentino P, Montarolo F, Sala A, Reindl M, Lo Re M, Chiodega V, Branger P, Audoin B, Aboab J, Papeix C, Collongues N, Kerschen P, Zephir H, Créange A, Bourre B, Schanda K, Flanagan EP, Redenbaugh V, Villacieros-Álvarez J, Arrambide G, Cobo-Calvo A, Ferrari S, Marignier R, Mariotto S. Serum Biomarker Profiles Discriminate AQP4 Seropositive and Double Seronegative Neuromyelitis Optica Spectrum Disorder. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2024; 11:e200188. [PMID: 38134369 PMCID: PMC10753928 DOI: 10.1212/nxi.0000000000200188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 10/10/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND AND OBJECTIVES Glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) serum levels are useful to define disease activity in different neurologic conditions. These biomarkers are increased in patients with aquaporin-4 antibody-positive NMOSD (AQP4+NMOSD) during clinical attacks suggesting a concomitant axonal and glial damage. However, there are contradictory results in double seronegative NMOSD (DS-NMOSD). The aim of this study was to characterize the neuronal, axonal, and glial damage of DS-NMOSD in comparison with AQP4+NMOSD. METHODS Patients with DS-NMOSD (i.e., for AQP4 and myelin oligodendrocyte glycoprotein antibodies-MOG-Abs) and age-matched AQP4+NMOSD diagnosed according to the latest diagnostic criteria and with available serum samples obtained within 3 months from onset/relapse were retrospectively enrolled from 14 international centers. Clinical and radiologic data were collected. Serum NfL, GFAP, tau, and UCH-L1 levels were determined using an ultrasensitive paramagnetic bead-based ELISA (SIMOA). Statistical analysis was performed using nonparametric tests and receiver-operating characteristic (ROC) curve analysis. RESULTS We included 25 patients with AQP4+NMOSD and 26 with DS-NMOSD. The median age at disease onset (p = 0.611) and female sex predominance (p = 0.072) were similar in the 2 groups. The most common syndromes at sampling in both AQP4+NMOSD and DS-NMOSD were myelitis (56% vs 38.5%) and optic neuritis (34.6% vs 32%), with no statistical differences (p = 0.716). Median EDSS at sampling was 3.2 (interquartile range [IQR] 2-7.7) in the AQP4+NMOSD group and 4 (IQR [3-6]) in the DS-NMOSD group (p = 0.974). Serum GFAP, tau, and UCH-L1 levels were higher in patients with AQP4+NMOSD compared with those with DS-NMOSD (median 308.3 vs 103.4 pg/mL p = 0.001; median 1.2 vs 0.5 pg/mL, p = 0.001; and median 61.4 vs 35 pg/mL, p = 0.006, respectively). The ROC curve analysis showed that GFAP, tau, and UCH-L1, but not NfL, values were able to discriminate between AQP4+ and DS-NMOSD (area under the curve (AUC) tau: 0.782, p = 0.001, AUC GFAP: 0.762, p = 0.001, AUC UCH-L1: 0.723, p = 0.006). NfL levels were associated with EDSS at nadir only in patients with AQP4+NMOSD. DISCUSSION Serum GFAP, tau, and UCH-L1 levels discriminate between AQP4+NMOSD and DS-NMOSD. The different biomarker profile of AQP4+NMOSD vs DS-NMOSD suggests heterogeneity of diseases within the latter category and provides useful data to improve our understanding of this disease.
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Affiliation(s)
- Sara Carta
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Alessandro Dinoto
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Marco Capobianco
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Paola Valentino
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Francesca Montarolo
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Arianna Sala
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Markus Reindl
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Marianna Lo Re
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Vanessa Chiodega
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Pierre Branger
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Bertrand Audoin
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Jennifer Aboab
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Caroline Papeix
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Nicolas Collongues
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Philippe Kerschen
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Helene Zephir
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Alain Créange
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Bertrand Bourre
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Kathrin Schanda
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Eoin P Flanagan
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Vyanka Redenbaugh
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Javier Villacieros-Álvarez
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Georgina Arrambide
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Alvaro Cobo-Calvo
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Sergio Ferrari
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Romain Marignier
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
| | - Sara Mariotto
- From the Department of Neuroscience, Biomedicine, and Movement Science (S.C., A.D., V.C., S.M., S.F.), University of Verona; S. Croce e Carle Hospital (M.C.), Cuneo; CRESM Biobank (M.C.), Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (P.V., M.L.R.); CRESM Biobank (P.V., M.L.R.), University Hospital San Luigi, Orbassano; Neurobiology Laboratory, Department of Neurology (A.S.), University Hospital San Luigi, Orbassano; Neuroscience Institute Cavalieri Ottolenghi (NICO) (F.M.), University of Turin, Italy; Clinical Department of Neurology (M.R., K.S.), Innsbruck Medical University, Austria; Department of Neurology (P.B.), CHU de Caen Normandie; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille University; Department of Internal Medecine (J.A.), Centre Hospitalier National des Quinze-Vingts, Paris Cedex; Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (C.P.), Institut du Cerveau, CIC Neuroscience, ICM, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris; Service de Neurologie and CIC INSERM 1434 (N.C.), CHU de Strasbourg, France; Centre Hospitalier de Luxembourg (P.K.), Luxembourg City, Luxemburg; Department of Neurology (H.Z.), U 1172, CRC-SEP, University Hospital of Lille, France; Service de Neurologie (A.C.), Centre de Ressources et de Compétences-Sclérose en Plaques, Assistance Publique des Hôpitaux de Paris, Groupe Hospitalier Henri Mondor, Université Paris-Est Créteil, Créteil; Department of Neurology (B.B.), Rouen University Hospital, France; Mayo Clinic College of Medicine and Science (E.P.F., V.R.), Department of Neurology, Department of Laboratory Medicine and Pathology, Rochester; Centre d'Esclerosi Múltiple de Catalunya (J.V.-Á., G.A., A.C.-C.), (CEMCAT), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Servei de Neurologia-Neuroimmunologia, Barcelona; and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, France
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Co DO. Acquired Demyelinating Syndromes. Med Clin North Am 2024; 108:93-105. [PMID: 37951658 DOI: 10.1016/j.mcna.2023.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
Acquired demyelinating syndromes (ADS) are a heterogenous group of inflammatory demyelinating conditions that include presentations of optic neuritis, transverse myelitis, and acute demyelinating encephalomyelitis. They can be monophasic or can develop into relapsing episodes of the initial demyelinating event or evolve to include other types of demyelination. Significant progress has been made in differentiating subtypes of ADS that differ in their tendency to relapse and in which anti-inflammatory therapies are effective. Differentiating between these subtypes is important for the optimal management of these patients. Clinical features, labs (especially autoantibodies), and MRI findings can help to differentiate between the different ADS.
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Affiliation(s)
- Dominic O Co
- Division of Allergy, Immunology, Rheumatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Clinical Science Center (CSC), H6/572, 600 Highland Avenue, Madison, WI 53792, USA.
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Santoro JD, Jafarpour S, Boyd NK, Nguyen L, Khoshnood MM. The Impact of Neuroimmunologic Disease and Developing Nervous System. Pediatr Neurol 2023; 148:189-197. [PMID: 37442652 DOI: 10.1016/j.pediatrneurol.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 05/16/2023] [Accepted: 06/10/2023] [Indexed: 07/15/2023]
Abstract
Over the last two decades, neuroimmunologic disorders of childhood have been increasingly described, phenotyped, and treated. These disorders remain rare in the general population and while sharing common therapeutic interventions due to their immune pathophysiology, are heterogeneous with regard to presentation and risk of recurrence. As such, the impact of these disorders on the developing brain has come into the forefront of emerging research in pediatric neuroimmunology. Investigations into the singular impact of monophasic disease on long-term development and the impact of early and aggressive disease-modifying therapy in relapsing conditions are quickly becoming areas of ripe investigation as the field's most optimal way to treat and monitor these conditions over time. Although critically important in evaluating the developing brain, research has been heterogeneous among these diseases and limited by small cohort size. This narrative review details the role of common neuroimmunologic disorders in long-term neurological and cognitive outcomes in children as they develop.
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Affiliation(s)
- Jonathan D Santoro
- Division of Neurology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California; Department of Neurology, Keck School of Medicine of the University of Southern California, Los Angeles, California.
| | - Saba Jafarpour
- Division of Neurology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California
| | - Natalie K Boyd
- Division of Neurology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California
| | - Lina Nguyen
- Division of Neurology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California
| | - Mellad M Khoshnood
- Division of Neurology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California
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Hor JY, Fujihara K. Epidemiology of myelin oligodendrocyte glycoprotein antibody-associated disease: a review of prevalence and incidence worldwide. Front Neurol 2023; 14:1260358. [PMID: 37789888 PMCID: PMC10542411 DOI: 10.3389/fneur.2023.1260358] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 08/15/2023] [Indexed: 10/05/2023] Open
Abstract
Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is an inflammatory demyelinating disease of the central nervous system (CNS) with the presence of conformation-sensitive antibodies against MOG. The spectrum of MOGAD includes monophasic/relapsing optic neuritis, myelitis, neuromyelitis optica spectrum disorder (NMOSD) phenotype without aquaporin 4 (AQP4) antibodies, acute/multiphasic demyelinating encephalomyelitis (ADEM/MDEM)-like presentation, and brainstem and cerebral cortical encephalitis. There is no apparent female preponderance in MOGAD, and MOGAD can onset in all age groups (age at onset is approximately 30 years on average, and approximately 30% of cases are in the pediatric age group). While prevalence and incidence data have been available for AQP4+ NMOSD globally, such data are only beginning to accumulate for MOGAD. We reviewed the currently available data from population-based MOGAD studies conducted around the world: three studies in Europe, three in Asia, and one joint study in the Americas. The prevalence of MOGAD is approximately 1.3-2.5/100,000, and the annual incidence is approximately 3.4-4.8 per million. Among White people, the prevalence of MOGAD appears to be slightly higher than that of AQP4+ NMOSD. No obvious latitude gradient was observed in the Japanese nationwide survey. The data available so far showed no obvious racial preponderance or strong HLA associations in MOGAD. However, precedent infection was reported in approximately 20-40% of MOGAD cases, and this is worthy of further investigation. Co-existing autoimmune disorders are less common in MOGAD than in AQP4+ NMOSD, but NMDAR antibodies may occasionally be positive in patients with MOGAD. More population-based studies in different populations and regions are useful to further inform the epidemiology of this disease.
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Affiliation(s)
- Jyh Yung Hor
- Department of Neurology, Penang General Hospital, Penang, Malaysia
| | - Kazuo Fujihara
- Department of Multiple Sclerosis Therapeutics, Fukushima Medical University School of Medicine, Koriyama, Japan
- Multiple Sclerosis and Neuromyelitis Optica Center, Southern TOHOKU Research Institute for Neuroscience, Koriyama, Japan
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Matsumoto Y, Kaneko K, Takahashi T, Takai Y, Namatame C, Kuroda H, Misu T, Fujihara K, Aoki M. Diagnostic implications of MOG-IgG detection in sera and cerebrospinal fluids. Brain 2023; 146:3938-3948. [PMID: 37061817 DOI: 10.1093/brain/awad122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 03/01/2023] [Accepted: 03/26/2023] [Indexed: 04/17/2023] Open
Abstract
The spectrum of MOG-IgG-associated disease (MOGAD) includes optic neuritis (ON), myelitis (MY), acute disseminated encephalomyelitis (ADEM), brainstem encephalitis, cerebral cortical encephalitis (CE) and AQP4-IgG-negative neuromyelitis optica spectrum disorder (NMOSD). In MOGAD, MOG-IgG are usually detected in sera (MOG-IgGSERUM), but there have been some seronegative MOGAD cases with MOG-IgG in CSF (MOG-IgGCSF), and its diagnostic implications remains unclear. In this cross-sectional study, we identified patients with paired serum and CSF sent from all over Japan for testing MOG-IgG. Two investigators blinded to MOG-IgG status classified them into suspected MOGAD (ADEM, CE, NMOSD, ON, MY and Others) or not based on the current recommendations. The MOG-IgGSERUM and MOG-IgGCSF titres were assessed with serial 2-fold dilutions to determine end point titres [≥1:128 in serum and ≥1:1 (no dilution) in CSF were considered positive]. We analysed the relationship between MOG-IgGSERUM, MOG-IgGCSF and the phenotypes with multivariable regression. A total of 671 patients were tested [405 with suspected MOGAD, 99 with multiple sclerosis, 48 with AQP4-IgG-positive NMOSD and 119 with other neurological diseases (OND)] before treatment. In suspected MOGAD, 133 patients (33%) tested MOG-IgG-positive in serum and/or CSF; 94 (23%) double-positive (ADEM 36, CE 15, MY 8, NMOSD 9, ON 15 and Others 11); 17 (4.2%) serum-restricted-positive (ADEM 2, CE 0, MY 3, NMOSD 3, ON 5 and Others 4); and 22 (5.4%) CSF-restricted-positive (ADEM 3, CE 4, MY 6, NMOSD 2, ON 0 and Others 7). None of AQP4-IgG-positive NMOSD, multiple sclerosis or OND cases tested positive for MOG-IgGSERUM, but two with multiple sclerosis cases were MOG-IgGCSF-positive; the specificities of MOG-IgGSERUM and MOG-IgGCSF in suspected MOGAD were 100% [95% confidence interval (CI) 99-100%] and 99% (95% CI 97-100%), respectively. Unlike AQP4-IgG-positive NMOSD, the correlation between MOG-IgGSERUM and MOG-IgGCSF titres in MOGAD was weak. Multivariable regression analyses revealed MOG-IgGSERUM was associated with ON and ADEM, whereas MOG-IgGCSF was associated with ADEM and CE. The number needed to test for MOG-IgGCSF to diagnose one additional MOGAD case was 13.3 (14.3 for ADEM, 2 for CE, 19.5 for NMOSD, infinite for ON, 18.5 for MY and 6.1 for Others). In terms of MOG-IgGSERUM/CSF status, most cases were double-positive while including either serum-restricted (13%) or CSF-restricted (17%) cases. These statuses were independently associated with clinical phenotypes, especially in those with ON in serum and CE in CSF, suggesting pathophysiologic implications and the utility of preferential diagnostic testing. Further studies are warranted to deduce the clinical and pathological significance of compartmentalized MOG-IgG.
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Affiliation(s)
- Yuki Matsumoto
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
| | - Kimihiko Kaneko
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Department of Neurology, Tohoku University Hospital, Sendai 980-8574, Japan
| | - Toshiyuki Takahashi
- Department of Neurology, National Hospital Organization Yonezawa National Hospital, Yonezawa 992-1202, Japan
| | - Yoshiki Takai
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Department of Neurology, Tohoku University Hospital, Sendai 980-8574, Japan
| | - Chihiro Namatame
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
| | - Hiroshi Kuroda
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
| | - Tatsuro Misu
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Department of Neurology, Tohoku University Hospital, Sendai 980-8574, Japan
| | - Kazuo Fujihara
- Department of Multiple Sclerosis Therapeutics, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Masashi Aoki
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
- Department of Neurology, Tohoku University Hospital, Sendai 980-8574, Japan
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Coles AJ. Chasing MOG antibodies down … assays and lumbar punctures. Brain 2023; 146:3559-3560. [PMID: 37656888 DOI: 10.1093/brain/awad271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023] Open
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20
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Moheb N, Chen JJ. The neuro-ophthalmological manifestations of NMOSD and MOGAD-a comprehensive review. Eye (Lond) 2023; 37:2391-2398. [PMID: 36928226 PMCID: PMC10397275 DOI: 10.1038/s41433-023-02477-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/07/2023] [Accepted: 02/28/2023] [Indexed: 03/18/2023] Open
Abstract
Optic neuritis (ON) is one of the most frequently seen neuro-ophthalmic causes of vision loss worldwide. Typical ON is often idiopathic or seen in patients with multiple sclerosis, which is well described in the landmark clinical trial, the Optic Neuritis Treatment Trial (ONTT). However, since the completion of the ONTT, there has been the discovery of aquaporin-4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG) antibodies, which are biomarkers for neuromyelitis optica spectrum disorder (NMOSD) and MOG antibody-associated disease (MOGAD), respectively. These disorders are associated with atypical ON that was not well characterised in the ONTT. The severity, rate of recurrence and overall outcome differs in these two entities requiring prompt and accurate diagnosis and management. This review will summarise the characteristic neuro-ophthalmological signs in NMOSD and MOGAD, serological markers and radiographic findings, as well as acute and long-term therapies used for these disorders.
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Affiliation(s)
- Negar Moheb
- Department of Ophthalmology and Neurology, Mayo Clinic, Rochester, MN, USA
| | - John J Chen
- Department of Ophthalmology and Neurology, Mayo Clinic, Rochester, MN, USA.
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Midaglia L, Felipe-Rucián A, Delgado Alvarez I, Montalban X, Tintoré M. Diagnostic challenge in children with an acquired demyelinating syndrome: an illustrative case report. Front Neurosci 2023; 17:1205065. [PMID: 37547139 PMCID: PMC10399123 DOI: 10.3389/fnins.2023.1205065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/04/2023] [Indexed: 08/08/2023] Open
Abstract
The clinical-radiological and biological overlap of the spectrum of pediatric demyelinating disorders makes the diagnostic process of a child with an acquired demyelinating syndrome truly challenging. We present a 9-year-old girl with subacute symptoms of severe decrease in bilateral visual acuity and gait ataxia. An urgent MRI showed inflammatory-demyelinating lesions affecting the periaqueductal gray matter, the cerebellar hemispheres, the area postrema as well as both optic nerves and chiasm. Likewise, multisegmental involvement of the cervical and dorsal spinal cord was found, with short and peripheral lesions. Anti myelin oligodendrocyte glycoprotein (MOG) antibodies (Abs) were positive in cerebrospinal fluid (CSF) and weakly in serum. Oligoclonal bands (OB) were positive in CSF. Based on all this, the diagnosis of MOG antibody disease (MOGAD) with a neuromyelitis optica spectrum disorder (NMOSD)-like picture was made. Given the good clinical and radiological recovery after the acute phase treatment, and that anti MOG Abs became negative, it was decided to keep the patient without specific treatment. However, during follow-up, while the patient was asymptomatic, a control brain MRI showed the appearance of new lesions with morphology and topography suggestive of multiple sclerosis (MS). This, added to the presence of OB, made the diagnosis of pediatric-onset MS (POMS) likely. Immunosuppressive treatment was restarted with a good response since then. Unlike adult-onset MS, children with POMS may usually not have entirely typical clinical and radiological features at presentation. In many cases, the time factor and close clinical and radiological monitoring could be critical to make an accurate diagnosis.
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Affiliation(s)
- Luciana Midaglia
- Servei de Neurologia/Neuroimmunologia, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ana Felipe-Rucián
- Secció de Neurologia Pediàtrica, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ignacio Delgado Alvarez
- Servei de Radiología, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Xavier Montalban
- Servei de Neurologia/Neuroimmunologia, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mar Tintoré
- Servei de Neurologia/Neuroimmunologia, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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22
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Al-Ani A, Chen JJ, Costello F. Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD): current understanding and challenges. J Neurol 2023:10.1007/s00415-023-11737-8. [PMID: 37154894 PMCID: PMC10165591 DOI: 10.1007/s00415-023-11737-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/15/2023] [Accepted: 04/17/2023] [Indexed: 05/10/2023]
Abstract
New diagnostic criteria for myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) have recently been proposed, distinguishing this syndrome from other inflammatory diseases of the central nervous system. Seropositivity status for MOG-IgG autoantibodies is important for diagnosing MOGAD, but only in the context of robust clinical characterization and cautious interpretation of neuroimaging. Over the last several years, access to cell-based assay (CBA) techniques has improved diagnostic accuracy, yet the positive predictive value of serum MOG-IgG values varies with the prevalence of MOGAD in any given patient population. For this reason, possible alternative diagnoses need to be considered, and low MOG-IgG titers need to be carefully weighted. In this review, cardinal clinical features of MOGAD are discussed. Key challenges to the current understanding of MOGAD are also highlighted, including uncertainty regarding the specificity and pathogenicity of MOG autoantibodies, the need to identify immunopathologic targets for future therapies, the quest to validate biomarkers that facilitate diagnosis and detect disease activity, and the importance of deciphering which patients with MOGAD require long-term immunotherapy.
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Affiliation(s)
- Abdullah Al-Ani
- Section of Ophthalmology, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - John J Chen
- Department of Ophthalmology and Neurology, Mayo Clinic, Rochester, MN, USA
| | - Fiona Costello
- Section of Ophthalmology, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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23
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Kim HJ, Palace J. Should We test for IgG Antibodies Against MOG in Both Serum and CSF in Patients With Suspected MOGAD? Neurology 2023; 100:497-498. [PMID: 36526427 DOI: 10.1212/wnl.0000000000206805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022] Open
Affiliation(s)
- Ho Jin Kim
- From the Department of Neurology (H.J.K.), Research Institute and Hospital of National Cancer Center, Goyang, Korea; and Nuffield Department of Clinical Neurosciences (J.P.), John Radcliffe Hospital, University of Oxford, United Kingdom.
| | - Jacqueline Palace
- From the Department of Neurology (H.J.K.), Research Institute and Hospital of National Cancer Center, Goyang, Korea; and Nuffield Department of Clinical Neurosciences (J.P.), John Radcliffe Hospital, University of Oxford, United Kingdom
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24
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Corbali O, Chitnis T. Pathophysiology of myelin oligodendrocyte glycoprotein antibody disease. Front Neurol 2023; 14:1137998. [PMID: 36925938 PMCID: PMC10011114 DOI: 10.3389/fneur.2023.1137998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/09/2023] [Indexed: 03/08/2023] Open
Abstract
Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOGAD) is a spectrum of diseases, including optic neuritis, transverse myelitis, acute disseminated encephalomyelitis, and cerebral cortical encephalitis. In addition to distinct clinical, radiological, and immunological features, the infectious prodrome is more commonly reported in MOGAD (37-70%) than NMOSD (15-35%). Interestingly, pediatric MOGAD is not more aggressive than adult-onset MOGAD, unlike in multiple sclerosis (MS), where annualized relapse rates are three times higher in pediatric-onset MS. MOGAD pathophysiology is driven by acute attacks during which T cells and MOG antibodies cross blood brain barrier (BBB). MOGAD lesions show a perivenous confluent pattern around the small veins, lacking the radiological central vein sign. Initial activation of T cells in the periphery is followed by reactivation in the subarachnoid/perivascular spaces by MOG-laden antigen-presenting cells and inflammatory CSF milieu, which enables T cells to infiltrate CNS parenchyma. CD4+ T cells, unlike CD8+ T cells in MS, are the dominant T cell type found in lesion histology. Granulocytes, macrophages/microglia, and activated complement are also found in the lesions, which could contribute to demyelination during acute relapses. MOG antibodies potentially contribute to pathology by opsonizing MOG, complement activation, and antibody-dependent cellular cytotoxicity. Stimulation of peripheral MOG-specific B cells through TLR stimulation or T follicular helper cells might help differentiate MOG antibody-producing plasma cells in the peripheral blood. Neuroinflammatory biomarkers (such as MBP, sNFL, GFAP, Tau) in MOGAD support that most axonal damage happens in the initial attack, whereas relapses are associated with increased myelin damage.
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Affiliation(s)
- Osman Corbali
- Harvard Medical School, Boston, MA, United States.,Department of Neurology, Brigham and Women's Hospital, Ann Romney Center for Neurologic Diseases, Boston, MA, United States
| | - Tanuja Chitnis
- Harvard Medical School, Boston, MA, United States.,Department of Neurology, Brigham and Women's Hospital, Ann Romney Center for Neurologic Diseases, Boston, MA, United States
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