The Frequency of Anti-Aquaporin-4 Ig G Antibody in Neuromyelitis Optica and Its Spectrum Disorders at a Single Tertiary Referral Center in Malaysia

Shanthi, Vissa; Arip, Masita; Mustafa, Norhazlin; Dhaliwal, Jasbir; Rose, N.; Muda, Sobri; Puvanarajah, Santhi Datuk; Rafia, M.H.; Loong, Mark Cheong Wing

doi:10.1155/2014/568254

Cited by 13 publications

(13 citation statements)

References 23 publications

(48 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Repeated reports found a positive correlation between tonic spasms and anti AQP‐seropositivity . In our study, all but 1 patient with SMDs were seropositive.…”

Section: Discussionsupporting

confidence: 47%

“…Repeated reports found a positive correlation between tonic spasms and anti AQP-seropositivity. 2,20 In our study, all but 1 patient with SMDs were seropositive. However, there was no significant difference in serostatus between those with SMDs and those without, probably because of the generally limited number of seronegative cases in our cohort.…”

Section: Discussionsupporting

confidence: 47%

See 1 more Smart Citation

Spinal Movement Disorders in Neuromyelitis Optica: An Under‐recognized Phenomenon

Abboud

Fernández

Mealy

et al. 2016

Movement Disord Clin Pract

View full text Add to dashboard Cite

Background: Spinal cord demyelination can cause several movement disorders. Although these abnormal movements could be the presenting symptom of the disease and, at times, the major source of disability, they are often overlooked, mislabeled, or undertreated. The aims of this study were to clearly define and establish common terminology for spinal movement disorders (SMDs) and characterize their full spectrum in patients with neuromyelitis optica (NMO). Methods: We chart reviewed 37 patients with NMO or NMO spectrum disorder. We classified spinal movement disorders under five categories: tonic spasms; focal dystonia; spinal myoclonus; spontaneous clonus; and tremors of spinal origin. We examined clinical, MRI, and medication data of symptomatic patients. Results: Of the 37 patients (86.4% female; mean age: 51 AE 17 years; mean disease duration: 9.4 AE 5.3 years), 16 (43.2%) had one or more form of SMDs. Compared to those without SMDs, patients with SMDs were generally older at presentation and were less likely to be African Americans. An abnormal movement was the main complaint in at least one posthospitalization visit in all symptomatic patients. Thirteen (35.1%) patients had paroxysmal tonic spasms, 2 (5.4%) had focal dystonia, 3 (8%) had postural/ action tremors, and no patient had spinal myoclonus or spontaneous clonus. In 9 patients, spasms were painful. There was no signal abnormality in the basal ganglia or the brainstem/cerebellum in any of the symptomatic patients. Conclusions: SMDs are common in NMO and are often a major source of disability. Using clear, unified terminology to describe SMDs is crucial for both clinical and research purposes.The prototype pathological substrates for movement disorders are the basal ganglia, other deep subcortical nuclei, the cerebellum, and their connections in the brainstem.

show abstract

“…Repeated reports found a positive correlation between tonic spasms and anti AQP‐seropositivity . In our study, all but 1 patient with SMDs were seropositive.…”

Section: Discussionsupporting

confidence: 47%

Section: Discussionsupporting

confidence: 47%

Spinal Movement Disorders in Neuromyelitis Optica: An Under‐recognized Phenomenon

Abboud

Fernández

Mealy

et al. 2016

Movement Disord Clin Pract

View full text Add to dashboard Cite

show abstract

“…Notably, cohorts from China comprised the vast majority of the Asian cohorts in our study. However, relatively high seroprevalence of AQP4-IgG and/or MOG-IgG in ON has been reported in several studies (that did not however fully fulfill our inclusion criteria) from Japan, Thailand, Malaysia, and additional Chinese centers ( 74 , 77 , 86 – 89 ). Importantly, while population-based studies support the notion that Eastern Asian populations have a higher prevalence of NMOSD compared to Caucasian populations, MOG-IgG-associated disease does not appear to exhibit a significant racial preponderance based on data from existing hospital-based studies ( 90 ).…”

Section: Discussionmentioning

confidence: 81%

AQP4-IgG and MOG-IgG Related Optic Neuritis—Prevalence, Optical Coherence Tomography Findings, and Visual Outcomes: A Systematic Review and Meta-Analysis

et al. 2020

View full text Add to dashboard Cite

Background: Optic neuritis (ON) is a cardinal manifestation of multiple sclerosis (MS), aquaporin-4 (AQP4)-IgG-, and myelin oligodendrocyte glycoprotein (MOG)-IgG-associated disease. However, the prevalence of AQP4-IgG seropositivity and MOG-IgG seropositivity in isolated ON is unclear, and studies comparing visual outcomes and optical coherence tomography (OCT)-derived structural retinal measures between MS-ON, AQP4-ON, and MOG-ON eyes are limited by small sample sizes. Objectives: (1) To assess the prevalence of AQP4-IgG and MOG-IgG seropositivity among patients presenting with isolated ON; (2) to compare visual outcomes and OCT measures between AQP4-ON, MOG-ON, and MS-ON eyes. Methods: In this systematic review and meta-analysis, a total of 65 eligible studies were identified by PubMed search. Statistical analyses were performed with random effects models. Results: In adults with isolated ON, AQP4-IgG seroprevalence was 4% in non-Asian and 27% in Asian populations, whereas MOG-IgG seroprevalence was 8 and 20%, respectively. In children, AQP4-IgG seroprevalence was 0.4% in non-Asian and 15% in Asian populations, whereas MOG-IgG seroprevalence was 47 and 31%, respectively. AQP4-ON eyes had lower peri-papillary retinal nerve fiber layer (pRNFL; −11.7 μm, 95% CI: −15.2 to −8.3 μm) and macular ganglion cell + inner plexiform layer (GCIPL; −9.0 μm, 95% CI: −12.5 to −5.4 μm) thicknesses compared with MS-ON eyes. Similarly, pRNFL (−11.2 μm, 95% CI: −21.5 to −0.9 μm) and GCIPL (−6.1 μm, 95% CI: −10.8 to −1.3 μm) thicknesses were lower in MOG-ON compared to MS-ON eyes, but did not differ between AQP4-ON and MOG-ON eyes (pRNFL: −1.9 μm, 95% CI: −9.1 to 5.4 μm; GCIPL: −2.6 μm, 95% CI: −8.9 to 3.8 μm). Visual outcomes were worse in AQP4-ON compared to both MOG-ON (mean logMAR difference: 0.60, 95% CI: 0.39 to 0.81) and MS-ON eyes (mean logMAR difference: 0.68, 95% CI: 0.40 to 0.96) but were similar in MOG-ON and MS-ON eyes (mean logMAR difference: 0.04, 95% CI: −0.05 to 0.14). Conclusions: AQP4-IgG- and MOG-IgG-associated disease are important diagnostic considerations in adults presenting with isolated ON, especially in Asian populations. Furthermore, MOG-IgG seroprevalence is especially high in pediatric isolated ON, in both non-Asian and Asian populations. Despite a similar severity of GCIPL and pRNFL thinning in AQP4-ON and MOG-ON, AQP4-ON is associated with markedly worse visual outcomes.

show abstract

“…Multiple studies have examined the impact imposed by the presence of autoantibody against AQP4 on the disease outcome in patients with NMOSD, and a strong correlation has been found between the serological titer and clinical features (including visual acuity), severity, disease activity, stabilization, and prognosis (Siritho et al, 2011;Apiwattanakul et al, 2012;Estiasari et al, 2012;Jarius et al, 2012;Siritho et al, 2014;Sasitorn et al, 2014;Viswanathan et al, 2014;Jarius et al, 2008;Takahashi et al, 2007). In particular, poor visual acuity outcomes have been found in individuals with AQP4seropositive NMOSD in a meta-analysis by Lin et al, which examined 624 AQP4-positive and 119 AQP4-negative patients.…”

Section: Introductionmentioning

confidence: 99%

The relationship between aquaporin-4 antibody status and visual tract integrity in neuromyelitis optica spectrum disorders: A visual evoked potential study

Barć

Gospodarczyk-Szot

Nojszewska

et al. 2020

Multiple Sclerosis and Related Disorders

View full text Add to dashboard Cite

Background: Optic neuritis (ON) is one of the hallmark symptomatic features of neuromyelitis optica spectrum disorders (NMOSD). The majority of patients with NMOSD present highly specific autoantibodies against aquaporin-4 (AQP4). A number of studies have reported poor visual acuity outcomes in individuals with AQP4 seropositive NMOSD, but no such relationship has been found with regard to visual evoked potentials (VEP) parameters such as the amplitude and latency of the P100 component. In this paper, we aimed (i) to describe VEP responses in patients with NMOSD; (ii) to analyze those results based on a scoring system; and (iii) to investigate the association between the VEPs and AQP4 antibody status. Methods: We retrospectively analysed the VEP responses of 40 patients with a diagnosis of NMOSD (according to the 2015 IPND criteria), including 16 with AQP4-postive status (AQP4[+]) and 24 with AQP4-negative status (AQP4[-]). In the first step, we measured the P100 peak latency and P100-N2 peak-to-peak amplitude in each patient. In the second, we converted these measures to the VEP score (0-10) using the scoring proposed by Jung et al. (2008). All recordings were performed using the same VEP device and testing protocol. Results: Abnormal VEPs were recorded in 25 of 40 patients (62.6%). Of these, 17 (42.5%) had prolonged P100 latency, and 8 (20%) had no response detected in at least one eye. The patients with ON as the initial relapse symptom had significantly higher median VEP scores than those who experienced the longitudinally extensive transverse myelitis (LETM) at the disease onset (7.0 [interquartile range (IQR), 2.0-8.0] vs. 0.0 [IQR, 0.0-4.0], p<0.001). A lack of VEP response in at least one eye was detected more frequently in the AQP4[+] group than the AQP4[-] group (7/16 vs. 1/24, p<0.005). Logistic regression model controlling for age, gender, disease duration, and the type of relapse at onset showed an independent impact of AQP4[+] status (OR=35.45, p = 0.018) on the higher rate of absent VEP responses. In the entire group of patients (n = 40), those with AQP4[+] showed a small tendency towards a higher median VEP score (4.0 [IQR, 0.0-7.8] vs. 1.0 [IQR, 0.0-4.0], p = 0.304). Among individuals with abnormal responses (n = 25), the patients with AQP4[+] had significantly higher median VEP scores (7.0 [IQR, 4.0-8.5] vs. 3.0 [IQR, 1.0-7.0], p = 0.034) and more common bilateral involvement of the optic tracts (80% vs. 40%, p = 0.048) than those who were seronegative for anti-AQP4 antibody. A median regression analysis model controlling for age, gender, disease duration, type of onset, and number of relapses in last 12 months showed an independent association between the AQP4-positive status and a higher VEP score in patients with NMOSD (t = 2.882, df=2, p = 0.007). Conclusion: VEP study remains a useful tool in the assessment of NMOSD patients. Due to the high prevalence of absent VEPs in NMOSD patients, the scoring system appears to be more applicable for the precise analysis of VEP recordings. There is a po...

show abstract

The Frequency of Anti-Aquaporin-4 Ig G Antibody in Neuromyelitis Optica and Its Spectrum Disorders at a Single Tertiary Referral Center in Malaysia

Cited by 13 publications

References 23 publications

Spinal Movement Disorders in Neuromyelitis Optica: An Under‐recognized Phenomenon

Spinal Movement Disorders in Neuromyelitis Optica: An Under‐recognized Phenomenon

AQP4-IgG and MOG-IgG Related Optic Neuritis—Prevalence, Optical Coherence Tomography Findings, and Visual Outcomes: A Systematic Review and Meta-Analysis

The relationship between aquaporin-4 antibody status and visual tract integrity in neuromyelitis optica spectrum disorders: A visual evoked potential study

Contact Info

Product

Resources

About