NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany.
NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany/Department of Neuroradiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Mult Scler. 2019 Dec;25(14):1926-1936. doi: 10.1177/1352458518815596. Epub 2018 Nov 26.
Spinal cord (SC) affection is a hallmark symptom of neuromyelitis optica spectrum disorders (NMOSD). Patients with aquaporin-4 (AQP4-IgG+) or myelin oligodendrocyte glycoprotein (MOG-IgG+) antibody seropositivity show this overlapping clinical phenotype.
Quantitative comparison of SC lesions and atrophy in AQP4-IgG+ and MOG-IgG+ NMOSD.
AQP4-IgG+ ( = 38), MOG-IgG+ ( = 15) NMOSD patients and healthy controls (HC, = 24) were analysed for SC lesion (prevalence, length, location), atrophy as mean upper cervical cord area (MUCCA), Expanded Disability Status Scale (EDSS), timed 25-foot walk speed (T25FWS) and 9-hole peg test (9HPT) measures.
In total, 92% (35/38) of AQP4-IgG+ and 53% (8/15) of MOG-IgG+ patients had myelitis attacks (χ = 6.47, = 0.011). 65.8%/26.7% of AQP4-/MOG-IgG+ patients had chronic SC lesions (χ = 5.16, = 0.023), with similar proportions in cervical, upper thoracic and lower thoracic cord, and no length differences. MUCCA was decreased in AQP4-IgG+ ( = -2.27, = 0.028), but not MOG-IgG+ patients ( = 0.58, = 0.57) compared to HC. MUCCA associated with myelitis attacks (rho = -0.33, = 0.016), EDSS (rho = -0.31, = 0.030), pyramidal functional score (rho = -0.42, = 0.003), T25FWS ( = 0.43, = 0.010) and 9HPT Z-score ( = 0.32, = 0.037), regardless of antibody status.
AQP4-IgG+ patients had more myelitis attacks, SC lesions and SC atrophy was more pronounced than in MOG-IgG+ patients. MUCCA is associated with clinical myelitis attacks and disability in all NMOSD patients.
脊髓（SC）受累是视神经脊髓炎谱系疾病（NMOSD）的标志性症状。水通道蛋白 4（AQP4-IgG+）或髓鞘少突胶质细胞糖蛋白（MOG-IgG+）抗体阳性的患者表现出这种重叠的临床表型。
定量比较 AQP4-IgG+和 MOG-IgG+NMOSD 患者的 SC 病变和萎缩。
对 38 例 AQP4-IgG+（=38）、15 例 MOG-IgG+（=15）NMOSD 患者和 24 例健康对照者（HC，=24）进行 SC 病变（患病率、长度、部位）、萎缩（平均颈髓面积 MUCCA）、扩展残疾状况量表（EDSS）、25 英尺步行速度（T25FWS）和 9 孔钉测试（9HPT）测量分析。
共有 92%（35/38）的 AQP4-IgG+和 53%（8/15）的 MOG-IgG+患者发生了脊髓炎发作（χ²=6.47，=0.011）。65.8%/26.7%的 AQP4-/MOG-IgG+患者有慢性 SC 病变（χ²=5.16，=0.023），在颈段、上胸段和下胸段的比例相似，长度无差异。与 HC 相比，AQP4-IgG+患者的 MUCCA 减少（=−2.27，=0.028），而 MOG-IgG+患者的 MUCCA 没有减少（=0.58，=0.57）。MUCCA 与脊髓炎发作（rho=−0.33，=0.016）、EDSS（rho=−0.31，=0.030）、锥体功能评分（rho=−0.42，=0.003）、T25FWS（=0.43，=0.010）和 9HPT Z 评分（=0.32，=0.037）相关，无论抗体状态如何。
AQP4-IgG+患者的脊髓炎发作更多，SC 病变和 SC 萎缩更为明显。在所有 NMOSD 患者中，MUCCA 与临床脊髓炎发作和残疾有关。
