MRI characteristics during attack and remission distinguish patients with MOG antibody-associated disease from multiple sclerosis.

IF 7.5 1区 医学 Q1 CLINICAL NEUROLOGY
Stephanie B Syc-Mazurek, Laura Cacciaguerra, Deena A Tajfirouz, Vyanka Redenbaugh, Karl N Krecke, Smathorn Thakolwiboon, Alessandro Dinoto, Ajay Madhavan, Jan-Mendelt Tillema, A Sebastian Lopez-Chiriboga, Cristina Valencia-Sanchez, Elia Sechi, John J Chen, Sean J Pittock, Eoin P Flanagan
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Abstract

Background: Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) and multiple sclerosis (MS) have both overlapping and distinct MRI lesion features, which vary with imaging timing. This study identified distinguishing MRI characteristics using paired MRIs at clinical attack and remission.

Methods: We retrospectively identified Mayo Clinic patients with MOGAD and MS that: (1) fulfilled respective diagnostic criteria; (2) had paired attack (≤30 days) and remission MRI scans (≥12 months) without interval attacks. MRIs were compared between groups for key features.

Results: We included 43 patients with MOGAD (median age 31 years (range, 3-67); 63% female) and 49 patients with MS (median age 39 years (range, 17-65); 65% female). Resolution of at least one T2-lesion differentiated MOGAD from MS (sensitivity, (95% CI 77% to 100%), specificity, (95% CI 86% to 99%); Youden's index (YI)=0.90). Resolution of at least two T2-lesions indicated MOGAD (sensitivity 62% (95% CI 41% to 79%); specificity, 100% (95% CI 94% to 100%); YI=0.62). MOGAD patients were more likely to have normal MRI scans at follow-up compared with MS (brain 14/44 (32%) vs 0/60 (0%), p<0.001; spine 21/27 (78%) vs 7/36 (19%), p<0.001). In addition, the presence of T1-hypointense, ovoid periventricular T2, and enhancing lesions were more common in MS versus MOGAD at attack and remission and in the spine, longitudinally extensive T2 lesions were more common in MOGAD attacks (8/27 (30%)).

Conclusion: Paired MRI at attack and remission revealed distinctive characteristics of MOGAD and MS, with greater diagnostic value at remission driven by the discriminating power of T2-lesion resolution. In MOGAD patients with initial parenchymal involvement, a 1-year follow-up MRI may aid diagnosis and serve as a new baseline.

发作和缓解期间的MRI特征可将MOG抗体相关疾病与多发性硬化症区分开来。
背景:髓鞘少突胶质细胞糖蛋白抗体相关疾病(MOGAD)和多发性硬化症(MS)具有重叠和独特的MRI病变特征,其随成像时间而变化。本研究在临床发作和缓解时使用配对MRI识别出不同的MRI特征。方法:我们回顾性地选取梅奥诊所患有MOGAD和MS的患者:(1)符合各自的诊断标准;(2)配对发作(≤30天)和缓解期MRI扫描(≥12个月),无间隔发作。比较各组间核磁共振成像的主要特征。结果:我们纳入了43例MOGAD患者(中位年龄31岁(范围3-67岁);63%女性)和49例MS患者(中位年龄39岁(范围17-65岁);65%的女性)。至少一个t2病变将MOGAD与MS区分开来(敏感性(95% CI 77% - 100%),特异性(95% CI 86% - 99%);约登指数(YI)=0.90)。至少两个t2病变的消退表明MOGAD(敏感性62% (95% CI 41% - 79%);特异性为100% (95% CI 94% ~ 100%);易= 0.62)。与MS相比,MOGAD患者随访时MRI扫描正常的可能性更大(脑14/44 (32%)vs 0/60(0%))。结论:发作期和缓解期MRI配对显示MOGAD和MS的明显特征,在t2病变分辨力的驱动下,缓解期具有更大的诊断价值。在MOGAD患者中,最初的实质受累者,1年的随访MRI可能有助于诊断并作为新的基线。
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来源期刊
CiteScore
15.70
自引率
1.80%
发文量
888
审稿时长
6 months
期刊介绍: The Journal of Neurology, Neurosurgery & Psychiatry (JNNP) aspires to publish groundbreaking and cutting-edge research worldwide. Covering the entire spectrum of neurological sciences, the journal focuses on common disorders like stroke, multiple sclerosis, Parkinson’s disease, epilepsy, peripheral neuropathy, subarachnoid haemorrhage, and neuropsychiatry, while also addressing complex challenges such as ALS. With early online publication, regular podcasts, and an extensive archive collection boasting the longest half-life in clinical neuroscience journals, JNNP aims to be a trailblazer in the field.
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