The impact of diagnostic criteria for neuromyelitis optica in patients with MS: a 10-year follow-up of the South Atlantic Project

Alvarenga, Regina Maria Papais; Vasconcelos, Cláudia Cristina Ferreira; Alves-Leon, Soniza Vieira; Batista, Elizabeth; Santos, Claudia Miranda; Camargo, Solange M.G.; Godoy, M. R.; Lacativa, Maria Clinete Sampaio; Lorenti, M.A.; Damasceno, Benito Pereira; Damasceno, Alfredo; Brum, Doralina Guimarães; Barreira, Amilton Antunes; Rocha, Maria Sheila Guimarães; Alvarenga, Hélcio; Tilbery, Charles Peter

doi:10.1177/1352458513495580

Cited by 20 publications

(14 citation statements)

References 31 publications

(71 reference statements)

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“…Despite the lower frequency of AD studies, the majority of them showed a worse outcome in the AD group. It is worth noting that two studies did not exclude patients with the diagnosis of neuromyelitis optica 15,26 , a circumstance that may have caused bias, due to neuromyelitis optica being more common in AD than CA patients 32 and having a more severe course. Diverse risk factors for severe progression have been identified and extensively discussed in the literature; nevertheless, these results are not always consistent between studies, due to different classifications and methods of analysis, and genetic variability of the studied populations.…”

Section: In 1962 Alter Published the Research Results Of Ms Inmentioning

confidence: 99%

Disability and progression in Afro-descendant patients with multiple sclerosis

Aurenção

Vasconcelos

Thuler

et al. 2016

Arq. Neuro-Psiquiatr.

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Multiple sclerosis (MS) prevalence is higher in Caucasian (CA) populations, narrowing the analysis of the impact of Afro-descendant (AD) populations in disease outcomes. Even so, recent studies observed that AD patients have a more severe course. The main objective of this study is to confirm and discuss, through a systematic review, that being AD is a risk factor for disability accumulation and/or severe progression in patients with MS. A systematic review of published data in the last eleven years was performed, which evaluated clinical aspects and long term disability in patients with MS. Fourteen studies were included. Of these fourteen articles, thirteen observed a relationship between ancestry and poorer outcome of MS. African ancestry is a condition inherent in the patient and should be considered as an initial clinical characteristic affecting prognosis, and influencing which therapeutic decision to make in initial phases.

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Section: In 1962 Alter Published the Research Results Of Ms Inmentioning

confidence: 99%

Disability and progression in Afro-descendant patients with multiple sclerosis

Aurenção

Vasconcelos

Thuler

et al. 2016

Arq. Neuro-Psiquiatr.

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“…The distribution of IIDD according to the new NMO and MS criteria has been investigated with regard to different populations. The results indicated the following relative frequencies of NMO cases among patients with MS: 1.2% in Australia [ 13 ], 1.5% in Italy [ 14 ], 8% in Mexico [ 15 ], 15.2% in southeastern Brazil [ 16 ], and 27% in Central America [ 17 ]. The highest frequency of cases featuring the selective involvement of the optic nerve and spinal cord s found in Japan, where 33% of patients with MS have Asian-type OSMS [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Central Nervous System Idiopathic Inflammatory Demyelinating Disorders in South Americans: A Descriptive, Multicenter, Cross-Sectional Study

et al. 2015

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The idiopathic inflammatory demyelinating disease (IIDD) spectrum has been investigated among different populations, and the results have indicated a low relative frequency of neuromyelitis optica (NMO) among multiple sclerosis (MS) cases in whites (1.2%-1.5%), increasing in Mestizos (8%) and Africans (15.4%-27.5%) living in areas of low MS prevalence. South America (SA) was colonized by Europeans from the Iberian Peninsula, and their miscegenation with natives and Africans slaves resulted in significant racial mixing. The current study analyzed the IIDD spectrum in SA after accounting for the ethnic heterogeneity of its population. A cross-sectional multicenter study was performed. Only individuals followed in 2011 with a confirmed diagnosis of IIDD using new diagnostic criteria were considered eligible. Patients’ demographic, clinical and laboratory data were collected. In all, 1,917 individuals from 22 MS centers were included (73.7% female, 63.0% white, 28.0% African, 7.0% Mestizo, and 0.2% Asian). The main disease categories and their associated frequencies were MS (76.9%), NMO (11.8%), other NMO syndromes (6.5%), CIS (3.5%), ADEM (1.0%), and acute encephalopathy (0.4%). Females predominated in all main categories. The white ethnicity also predominated, except in NMO. Except in ADEM, the disease onset occurred between 20 and 39 years old, early onset in 8.2% of all cases, and late onset occurred in 8.9%. The long-term morbidity after a mean disease time of 9.28±7.7 years was characterized by mild disability in all categories except in NMO, which was scored as moderate. Disease time among those with MS was positively correlated with the expanded disability status scale (EDSS) score (r=0.374; p=<0.001). This correlation was not observed in people with NMO or those with other NMO spectrum disorders (NMOSDs). Among patients with NMO, 83.2% showed a relapsing-remitting course, and 16.8% showed a monophasic course. The NMO-IgG antibody tested using indirect immunofluorescence (IIF) with a composite substrate of mouse tissues in 200 NMOSD cases was positive in people with NMO (95/162; 58.6%), longitudinally extensive transverse myelitis (10/30; 33.3%) and bilateral or recurrent optic neuritis (8/8; 100%). No association of NMO-IgG antibody positivity was found with gender, age at onset, ethnicity, early or late onset forms, disease course, or long-term severe disability. The relative frequency of NMO among relapsing-remitting MS (RRMS) + NMO cases in SA was 14.0%. Despite the high degree of miscegenation found in SA, MS affects three quarters of all patients with IIDD, mainly white young women who share similar clinical characteristics to those in Western populations in the northern hemisphere, with the exception of ethnicity; approximately one-third of all cases occur among non-white individuals. At the last assessment, the majority of RRMS patients showed mild disability, and the risk for secondary progression was significantly superior among those of African ethnicity. NMO comprises 11.8% of all IIDD cases in SA...

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“…The relative frequency of NMO to that of MS (NMO/MS ratio) was previously reported to be high in Thailand (1.4) [10] and Japan (0.29–0.59) [11,12], compared to that in Europe (0.024) [13] and Latin America (0.073–0.26) [14]. …”

Section: Introductionmentioning

confidence: 99%

Characterization of the spectrum of Korean inflammatory demyelinating diseases according to the diagnostic criteria and AQP4-Ab status

et al. 2014

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BackgroundThe relative frequencies of demyelinating diseases among Korean patients with idiopathic inflammatory demyelinating disease of the central nervous system (IIDD) have not been sufficiently studied. We therefore describe a cohort of 203 patients with IIDD from three centers in Korea whose syndromes were identified precisely according to international clinical criteria and autoantibody to aquaporin 4 (AQP4-Ab) status.MethodsIn total, 260 consecutive patients were screened and 203 were included from three hospitals in Korea. All were tested for AQP4-Ab by using a cell-based assay. Patients who met the criteria for definite neuromyelitis optica (NMO) or had a positive AQP4-Ab test result were defined as the NMO group. Among the others, patients were assessed if they had acute disseminated encephalomyelitis, multiple sclerosis (MS), acute transverse myelitis, optic neuritis, or other demyelinating disease as a clinically isolated syndrome of the brain.ResultsEighteen percent of patients were classified as the NMO group, 2% as acute disseminated encephalomyelitis, 18% as MS, 41% as acute transverse myelitis, 11% as optic neuritis, and 8% as other clinically isolated syndrome of the brain. AQP4-Ab was positive in 18% of patients and the relative frequency of NMO to MS (NMO/MS ratio) was 1.06. The mean duration of follow up in our patients was 64 months.ConclusionsAmong Korean patients with idiopathic inflammatory demyelinating diseases, the incidence of NMO may be similar to that of MS, and the overall positivity of AQP4-Ab could be lower than previously reported. In addition, acute transverse myelitis that is not associated with MS or NMO can be relatively common in these patients. Further population-based studies with AQP4-Ab are needed to determine the exact incidence of NMO and other idiopathic inflammatory demyelinating diseases in Korea.

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The impact of diagnostic criteria for neuromyelitis optica in patients with MS: a 10-year follow-up of the South Atlantic Project

Cited by 20 publications

References 31 publications

Disability and progression in Afro-descendant patients with multiple sclerosis

Disability and progression in Afro-descendant patients with multiple sclerosis

Central Nervous System Idiopathic Inflammatory Demyelinating Disorders in South Americans: A Descriptive, Multicenter, Cross-Sectional Study

Characterization of the spectrum of Korean inflammatory demyelinating diseases according to the diagnostic criteria and AQP4-Ab status

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