Myelin oligodendrocyte glycoprotein antibody-associated demyelination: comparison between onset phenotypes

Y. Zhou, X. Jia, H. Yang, C. Chen, X. Sun, L. Peng, A. G. Kermode, W. Qiu

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background and purpose The aim of this study was to analyse the clinical and prognostic features of myelin oligodendrocyte glycoprotein (MOG) antibody-associated demyelination with different onset phenotypes. Methods A total of 52 MOG-IgG-seropositive patients were divided into four groups: (i) optic neuritis (ON) at onset (MOG-ON+, n = 23), (ii) transverse myelitis (TM) at onset (MOG-TM+, n = 12), (iii) pure brain symptoms at onset (MOG-ON--TM-, n = 14) and (iv) both ON and TM at onset (n = 3). This final group was not included in further analyses. Data were collected through medical records and regular follow-up. Results Median age at presentation was 24 (range, 3-63) years in the whole cohort (50% female). MOG-ON--TM- patients had the youngest age of onset across the three groups. Patients with MOG-TM+ tended to relapse more frequently and had a longer interval to first relapse than was observed in MOG-ON+ and MOG-ON--TM- patients. High MOG-IgG titres were associated with increased cerebrospinal fluid leukocytes. The likelihood of harbouring transient, low MOG-IgG titres was higher in the MOG-TM+ group than in the other groups. After a median disease duration of 20 months, most but not all cases had a favourable outcome, with 8% developing severe visual deficit, 2% becoming wheelchair-dependent and 6% developing cognitive impairment. The onset phenotype appeared to be an important predictor of disability type. Having high MOG-IgG titres (odds ratio, 0.168, P = 0.027) or female gender (odds ratio, 0.270, P = 0.067) was associated with a lower likelihood of complete recovery.

Conclusions Onset phenotype may influence long-term presentation, MOG-IgG status as well as outcome. Further large and prospective studies are needed to better clarify the clinical implications of the first demyelinating event.

Original languageEnglish
Pages (from-to)175-183
Number of pages9
JournalEuropean Journal of Neurology
Volume26
Issue number1
DOIs
Publication statusPublished - Jan 2019

Cite this

Zhou, Y. ; Jia, X. ; Yang, H. ; Chen, C. ; Sun, X. ; Peng, L. ; Kermode, A. G. ; Qiu, W. / Myelin oligodendrocyte glycoprotein antibody-associated demyelination : comparison between onset phenotypes. In: European Journal of Neurology. 2019 ; Vol. 26, No. 1. pp. 175-183.
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abstract = "Background and purpose The aim of this study was to analyse the clinical and prognostic features of myelin oligodendrocyte glycoprotein (MOG) antibody-associated demyelination with different onset phenotypes. Methods A total of 52 MOG-IgG-seropositive patients were divided into four groups: (i) optic neuritis (ON) at onset (MOG-ON+, n = 23), (ii) transverse myelitis (TM) at onset (MOG-TM+, n = 12), (iii) pure brain symptoms at onset (MOG-ON--TM-, n = 14) and (iv) both ON and TM at onset (n = 3). This final group was not included in further analyses. Data were collected through medical records and regular follow-up. Results Median age at presentation was 24 (range, 3-63) years in the whole cohort (50{\%} female). MOG-ON--TM- patients had the youngest age of onset across the three groups. Patients with MOG-TM+ tended to relapse more frequently and had a longer interval to first relapse than was observed in MOG-ON+ and MOG-ON--TM- patients. High MOG-IgG titres were associated with increased cerebrospinal fluid leukocytes. The likelihood of harbouring transient, low MOG-IgG titres was higher in the MOG-TM+ group than in the other groups. After a median disease duration of 20 months, most but not all cases had a favourable outcome, with 8{\%} developing severe visual deficit, 2{\%} becoming wheelchair-dependent and 6{\%} developing cognitive impairment. The onset phenotype appeared to be an important predictor of disability type. Having high MOG-IgG titres (odds ratio, 0.168, P = 0.027) or female gender (odds ratio, 0.270, P = 0.067) was associated with a lower likelihood of complete recovery.Conclusions Onset phenotype may influence long-term presentation, MOG-IgG status as well as outcome. Further large and prospective studies are needed to better clarify the clinical implications of the first demyelinating event.",
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Myelin oligodendrocyte glycoprotein antibody-associated demyelination : comparison between onset phenotypes. / Zhou, Y.; Jia, X.; Yang, H.; Chen, C.; Sun, X.; Peng, L.; Kermode, A. G.; Qiu, W.

In: European Journal of Neurology, Vol. 26, No. 1, 01.2019, p. 175-183.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Myelin oligodendrocyte glycoprotein antibody-associated demyelination

T2 - comparison between onset phenotypes

AU - Zhou, Y.

AU - Jia, X.

AU - Yang, H.

AU - Chen, C.

AU - Sun, X.

AU - Peng, L.

AU - Kermode, A. G.

AU - Qiu, W.

PY - 2019/1

Y1 - 2019/1

N2 - Background and purpose The aim of this study was to analyse the clinical and prognostic features of myelin oligodendrocyte glycoprotein (MOG) antibody-associated demyelination with different onset phenotypes. Methods A total of 52 MOG-IgG-seropositive patients were divided into four groups: (i) optic neuritis (ON) at onset (MOG-ON+, n = 23), (ii) transverse myelitis (TM) at onset (MOG-TM+, n = 12), (iii) pure brain symptoms at onset (MOG-ON--TM-, n = 14) and (iv) both ON and TM at onset (n = 3). This final group was not included in further analyses. Data were collected through medical records and regular follow-up. Results Median age at presentation was 24 (range, 3-63) years in the whole cohort (50% female). MOG-ON--TM- patients had the youngest age of onset across the three groups. Patients with MOG-TM+ tended to relapse more frequently and had a longer interval to first relapse than was observed in MOG-ON+ and MOG-ON--TM- patients. High MOG-IgG titres were associated with increased cerebrospinal fluid leukocytes. The likelihood of harbouring transient, low MOG-IgG titres was higher in the MOG-TM+ group than in the other groups. After a median disease duration of 20 months, most but not all cases had a favourable outcome, with 8% developing severe visual deficit, 2% becoming wheelchair-dependent and 6% developing cognitive impairment. The onset phenotype appeared to be an important predictor of disability type. Having high MOG-IgG titres (odds ratio, 0.168, P = 0.027) or female gender (odds ratio, 0.270, P = 0.067) was associated with a lower likelihood of complete recovery.Conclusions Onset phenotype may influence long-term presentation, MOG-IgG status as well as outcome. Further large and prospective studies are needed to better clarify the clinical implications of the first demyelinating event.

AB - Background and purpose The aim of this study was to analyse the clinical and prognostic features of myelin oligodendrocyte glycoprotein (MOG) antibody-associated demyelination with different onset phenotypes. Methods A total of 52 MOG-IgG-seropositive patients were divided into four groups: (i) optic neuritis (ON) at onset (MOG-ON+, n = 23), (ii) transverse myelitis (TM) at onset (MOG-TM+, n = 12), (iii) pure brain symptoms at onset (MOG-ON--TM-, n = 14) and (iv) both ON and TM at onset (n = 3). This final group was not included in further analyses. Data were collected through medical records and regular follow-up. Results Median age at presentation was 24 (range, 3-63) years in the whole cohort (50% female). MOG-ON--TM- patients had the youngest age of onset across the three groups. Patients with MOG-TM+ tended to relapse more frequently and had a longer interval to first relapse than was observed in MOG-ON+ and MOG-ON--TM- patients. High MOG-IgG titres were associated with increased cerebrospinal fluid leukocytes. The likelihood of harbouring transient, low MOG-IgG titres was higher in the MOG-TM+ group than in the other groups. After a median disease duration of 20 months, most but not all cases had a favourable outcome, with 8% developing severe visual deficit, 2% becoming wheelchair-dependent and 6% developing cognitive impairment. The onset phenotype appeared to be an important predictor of disability type. Having high MOG-IgG titres (odds ratio, 0.168, P = 0.027) or female gender (odds ratio, 0.270, P = 0.067) was associated with a lower likelihood of complete recovery.Conclusions Onset phenotype may influence long-term presentation, MOG-IgG status as well as outcome. Further large and prospective studies are needed to better clarify the clinical implications of the first demyelinating event.

KW - demyelinating disorder

KW - myelin oligodendrocyte glycoprotein antibody-associated demyelination

KW - prognosis

KW - TREATMENT RESPONSES

KW - CNS

KW - CHILDREN

KW - DISEASE

U2 - 10.1111/ene.13791

DO - 10.1111/ene.13791

M3 - Article

VL - 26

SP - 175

EP - 183

JO - European Journal of Neurology

JF - European Journal of Neurology

SN - 1351-5101

IS - 1

ER -