Frequency of Asymptomatic Optic Nerve Enhancement in 203 Patients With MOG Antibody-Associated Disease.

IF 7.8 1区医学 Q1 CLINICAL NEUROLOGY

Neurology® Neuroimmunology & Neuroinflammation Pub Date : 2024-09-01 Epub Date: 2024-06-26 DOI:10.1212/NXI.0000000000200277

Deena Tajfirouz, Ajay Madhavan, Johann M Pacheco Marrero, Karl N Krecke, Kalli J Fautsch, Eoin P Flanagan, Sean J Pittock, Shailee Shah, M Tariq Bhatti, John J Chen

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Abstract

Background and objectives: Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a distinct CNS demyelinating disease. The rate of asymptomatic optic nerve enhancement on MRI has not been explored in patients with MOGAD. An improved understanding of this would guide clinical practice and assessment of treatment efficacy. We aimed to determine the frequency of asymptomatic optic nerve enhancement in MOGAD.

Methods: This was a retrospective review of patients evaluated at Mayo Clinic with MOGAD between January 1, 2000, and August 1, 2021 (median follow-up 1.6 [range 1-19] years). MRI studies were reviewed by masked neuroradiologists. Scans performed within 30 days of ON attack were classified as attack scans. Images obtained for routine surveillance, before ON attack, or at the time of non-ON attack were classified as interattack scans.

Results: Five hundred sixty-six MRIs (203 unique patients, 53% female) were included. Interattack MRIs represented 341 (60%) of the scans (median 36 days post-ON [range -1,032 to 6,001]). Of the interattack scans, 43 of 341 (13%), 30 unique patients, showed optic nerve enhancement. The enhancement was located at prior sites of ON in 35 of 43 (81%). Among the 8 patients with enhancement in new optic nerve areas, 6 had acute disseminated encephalomyelitis without an eye examination at the time of the MRI and 2 had preceding ON without imaging. Long-term visual outcomes showed no significant difference between those with and without asymptomatic enhancement, with improved visual acuity in most patients.

Discussion: Asymptomatic optic nerve enhancement occurred in 13% of interattack MRIs, the majority in patients with prior ON and occurring at prior sites of optic nerve enhancement. New asymptomatic optic nerve enhancement in areas without prior ON was rare. These findings are important for understanding the natural history of MOGAD, the interpretation of symptoms or response to treatment, and the adjudication of attacks in clinical trials.

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203 名 MOG 抗体相关疾病患者无症状视神经增强的频率。

背景和目的：髓鞘少突胶质细胞糖蛋白抗体相关疾病（MOGAD）是一种独特的中枢神经系统脱髓鞘疾病。磁共振成像上无症状视神经增强的比例尚未在 MOGAD 患者中进行探讨。对此的进一步了解将为临床实践和疗效评估提供指导。我们旨在确定 MOGAD 患者无症状视神经强化的频率：这是一项回顾性研究，研究对象是 2000 年 1 月 1 日至 2021 年 8 月 1 日期间在梅奥诊所接受评估的 MOGAD 患者（中位随访 1.6 [1-19] 年）。核磁共振成像研究由蒙面神经放射科医生进行审查。ON发作后30天内进行的扫描被归类为发作扫描。因常规监测、ON发作前或非ON发作时获得的图像被归类为发作间期扫描：结果：共纳入 566 例磁共振成像（203 例患者，53% 为女性）。发作间期磁共振成像占扫描总数的 341（60%）（中位数为 ON 后 36 天 [范围-1,032 至 6,001]）。在攻击间期扫描中，341 次扫描中有 43 次（13%），即 30 名患者出现视神经增强。43例中有35例（81%）的增强位于之前的ON部位。在新的视神经区域出现强化的 8 位患者中，有 6 位在进行核磁共振成像检查时患有急性播散性脑脊髓炎，但未进行眼部检查，有 2 位患者之前患有 ON，但未进行成像检查。长期视力结果显示，无症状强化和无症状强化患者的视力无明显差异，大多数患者的视力都有所改善：讨论：13%的发作间期核磁共振成像中出现了无症状视神经增强，其中大部分患者之前患有ON，并且发生在之前视神经增强的部位。既往无ON的区域出现新的无症状视神经增强的情况很少见。这些发现对于了解 MOGAD 的自然病史、解释症状或治疗反应以及在临床试验中判断发作非常重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurology® Neuroimmunology & Neuroinflammation Neuroscience-Neurology

CiteScore

15.60

自引率

2.30%

发文量

219

审稿时长

8 weeks

期刊介绍： Neurology Neuroimmunology & Neuroinflammation is an official journal of the American Academy of Neurology. Neurology: Neuroimmunology & Neuroinflammation will be the premier peer-reviewed journal in neuroimmunology and neuroinflammation. This journal publishes rigorously peer-reviewed open-access reports of original research and in-depth reviews of topics in neuroimmunology & neuroinflammation, affecting the full range of neurologic diseases including (but not limited to) Alzheimer's disease, Parkinson's disease, ALS, tauopathy, and stroke; multiple sclerosis and NMO; inflammatory peripheral nerve and muscle disease, Guillain-Barré and myasthenia gravis; nervous system infection; paraneoplastic syndromes, noninfectious encephalitides and other antibody-mediated disorders; and psychiatric and neurodevelopmental disorders. Clinical trials, instructive case reports, and small case series will also be featured.