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Neurology. 2018 May 22;90(21):e1858-e1869. doi: 10.1212/WNL.0000000000005560. Epub 2018 Apr 25.

Clinical spectrum and prognostic value of CNS MOG autoimmunity in adults: The MOGADOR study.

Collaborators (208)

Vukusic PS, Clanet PM, Brochet PB, Pelletier PJ, Moreau PT, De Seze PJ, Laplaud PD, Cotton PF, Fontaine PB, Stankoff PB, Casey DR, Maze DM, Olaiz DJ, Frangoulis DB, De Seze PJ, Debard N, Vukusic PS, Marignier DR, Durand-Dubief DF, Zorila DC, Debouverie PM, Guillemin PF, Mathey DG, Ziegler A, Edan PG, Le Page DE, Leray DE, Muraz R, Brassat PD, Clanet PM, Peaureaux-Averseng DD, Dewas C, Brochet PB, Ouallet DJ, Ruet DA, Kounkou KK, De Seze PJ, Collongues DN, Berthe C, Vermersch PP, Hautecoeur PP, Zephir DH, Deruelle F, Papeix DC, Maillard DE, Lubetzki PC, Lebrun-Frenay DC, Cohen DM, Callier C, Defer PG, Derache DN, Droulon K, Labauge PP, Ayrignac DX, Carra-Dalliere DC, Pinna F, Moreau PT, Fromont DA, Protin A, Laplaud PD, Michel DL, Wiertlewski DS, Jousset N, Berger DE, Chamard-Witkowski DL, Bereau DM, Cappe C, Clavelou PP, Taithe DF, Moisset DX, Dumont E, Pelletier PJ, Audoin PB, Rico-Lamy DA, Di Lelio B, Castelnovo DG, Thouvenot PE, Stankoff PB, Giannesini DC, Heinzlef DO, Fagniez DO, Laage DC, Bourre DB, Lefaucheur DR, Maltete DD, Vimont C, Al Khedr DA, Sehaki S, Gout DO, Bensa DC, Cabre PP, Kasonde DI, Galli P, Magy PL, Montcuquet DA, Nicol M, Casez DO, Vaillant DM, Diop Kane M, Camdessanche PJ, Visneux V, Guennnoc DA, Beltran DS, Meunier G, Creange PA, Ayache DS, Abdellaoui DM, Pottier DC, Slesari DI, Sampaio M, DeburghraeveƗ DV, Le Port D, Ciron DJ, Neau PJ, Rabois E, Labeyrie DC, Patry DI, Lescieux E, Nifle DC, Servan DJ, Pico PF, Chatagner V, Camus-Jacqmin DM, Henry DC, Bottin DL, Tourbah PA, Castex C, Diallo SS, Cotton PF, Dousset PV, Brisset JC, Anxionnat PR, Armspach PJ, Bannier E, Barillot DC, Berry PI, Bonneville PF, Cervenanski F, Commovick O, Defer PG, Durand-Dubief DF, Ferre DJ, Galanaud PD, Grand DS, Guttmann PC, Kremer DS, Ranjeva PJ, Sappey-Marinier DD, Tourbah PA, Tourdias DT, Lifticariu DC, Constans DJ, Tanguy DJ, Dousset PV, Tourdias DT, Dardel DP, Oesterle DH, Gonin DS, Ricolfi DF, Grand DS, Krainik DA, Boncoeur-Martel DM, Ameli DR, Bonhomme DG, Cotton PF, Roch DJ, Sappey-Marinier DD, Brunel H, Coze S, Girard N, Lehmann P, Ranjeva PJ, Menjot De Champfleur DN, Anxionnat PR, Desal DH, Mondot DL, Savatovsky DJ, Galanaud PD, Pyatigorskaya DN, Guillevin DR, Pierot DL, Barillot DC, Ferre DJ, Bannier E, Gerardin DE, Boutet DC, Kremer DS, Armspach PJ, Berry PI, Bonneville PF, Laplaud PD, Dufay N, Fontaine PB, Marignier DR, Thouvenot PE, Zephir DH, Zephir DH, Gele P, Marignier DR, Fiard G, Lehmann S, Lommazi S, Laplaud PD, Gallot G, Thouvenot PE, Fontaine PB, Rebeix I, Desille-Dugast M.

Abstract

OBJECTIVE:

To describe clinical and radiologic features associated with myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) in a large French nationwide adult cohort, to assess baseline prognostic features of MOG-Ab-associated diseases after a first acute demyelinating syndrome, and to evaluate the clinical value of MOG-Ab longitudinal analysis.

METHODS:

Clinical data were obtained from 197 MOG-Ab-positive patients ≥18 years of age. Complete imaging data were available in 108, and 54 serum samples were eligible for longitudinal evaluation. For survival analysis comparison, 169 aquaporin-4 antibody (AQP4-Ab)-positive patients from the NOMADMUS database were included.

RESULTS:

Median age at onset was 36.46 (range 18.0-76.8) years, and patients were predominantly white (92.9%) with male:female ratio, 1.1. Clinical phenotype at onset included optic neuritis or myelitis in 90.86%, isolated brainstem or encephalopathy syndromes in 6.6%, and a combination of syndromes in 2.5%. Distinctive brain MRI findings in MOG-Ab-positive patients were thalamic and pontine lesions. Cortical and leptomeningeal lesions were found in 16.3% and 6.1%, respectively. The probability of reaching a first relapse after 2 and 5 years was 44.8% and 61.8%, respectively. MOG-Ab-positive patients were at lower risk at presentation of further clinical relapse (hazard ratio [HR] 0.45, 95% confidence interval [CI] 0.26-0.79) compared to AQP4-Ab-positive individuals. MOG-Ab-positive individuals had a lower risk of reaching Disability Status Scale score of 3.0 (HR 0.46, 95% CI 0.22-0.94) and visual acuity of 20/100 (HR 0.23, 95% CI 0.07-0.72). Finally, MOG-Ab titers were higher at relapse than in remission (p = 0.009).

CONCLUSION:

In adults, MOG-Ab-associated disease extends beyond clinical and radiologic abnormalities in the optic nerve and spinal cord. Despite the relapsing course, the overall visual and motor outcome is better compared with AQP4-Ab-positive patients.

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