Revised diagnostic criteria for neuromyelitis optica
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TLDR
Revised diagnostic criteria for definite neuromyelitis optica (NMO) that require optic neuritis, myelitis, and at least two of three supportive criteria: MRI evidence of a contiguous spinal cord lesion 3 or more segments in length, onset brain MRI nondiagnostic for multiple sclerosis, or NMO-IgG seropositivity.Abstract:
Background: The authors previously proposed diagnostic criteria for neuromyelitis optica (NMO) that facilitate its distinction from prototypic multiple sclerosis (MS) However, some patients with otherwise typical NMO have additional symptoms not attributable to optic nerve or spinal cord inflammation or have MS-like brain MRI lesions Furthermore, some patients are misclassified as NMO by the authors’ earlier proposed criteria despite having a subsequent course indistinguishable from prototypic MS A serum autoantibody marker, NMO-IgG, is highly specific for NMO The authors propose revised NMO diagnostic criteria that incorporate NMO-IgG status Methods: Using final clinical diagnosis (NMO or MS) as the reference standard, the authors calculated sensitivity and specificity for each criterion and various combinations using a sample of 96 patients with NMO and 33 with MS The authors used likelihood ratios and logistic regression analysis to develop the most practical and informative diagnostic model Results: Fourteen patients with NMO (146%) had extra-optic-spinal CNS symptoms NMO-IgG seropositivity was 76% sensitive and 94% specific for NMO The best diagnostic combination was 99% sensitive and 90% specific for NMO and consisted of at least two of three elements: longitudinally extensive cord lesion, onset brain MRI nondiagnostic for MS, or NMO-IgG seropositivity Conclusions: The authors propose revised diagnostic criteria for definite neuromyelitis optica (NMO) that require optic neuritis, myelitis, and at least two of three supportive criteria: MRI evidence of a contiguous spinal cord lesion 3 or more segments in length, onset brain MRI nondiagnostic for multiple sclerosis, or NMO-IgG seropositivity CNS involvement beyond the optic nerves and spinal cord is compatible with NMOread more
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Journal ArticleDOI
Diagnostik und Therapie der Neuromyelitis optica
TL;DR: Die Neuromyelitis optica ist eine immunvermittelte, chronisch entzündliche Erkrankung des Zentralnervensystems, wobei schubförmig oder monophasisch Verläufe überwiegen (ca. 80–90% der Fälle).
Journal ArticleDOI
Fatigue in patients with neuromyelitis optica spectrum disorder and its impact on quality of life.
Jin Myoung Seok,Jin Myoung Seok,Misong Choi,Eun Bin Cho,Hye Lim Lee,Byoung Joon Kim,Kwang Ho Lee,Pamela Song,Eun Yeon Joo,Ju-Hong Min +9 more
TL;DR: Patients with NMOSD who were in remission and seropositive for anti-aquaporin-4 antibody were divided into 2 groups based on the presence of fatigue assessed using the Functional Assessment of Chronic Illness Therapy-fatigue score and QOL was evaluated.
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Cerebrospinal fluid α‐synuclein levels are elevated in multiple sclerosis and neuromyelitis optica patients during replase
Honghao Wang,Kai Wang,Wen Xu,Conghui Wang,Wei Qiu,Xiaonan Zhong,Yongqiang Dai,Aimin Wu,Xueqiang Hu +8 more
TL;DR: In this article, an enzyme-linked immunosorbent assay (ELISA) was used to measure CSF α-synuclein in multiple sclerosis (MS) and neuromyelitis optica (NMO) patients.
Journal ArticleDOI
Circulating microRNAs as biomarkers for rituximab therapy, in neuromyelitis optica (NMO).
Adi Vaknin-Dembinsky,Hanna Charbit,Livnat Brill,Oded Abramsky,Devorah Gur-Wahnon,Iddo Z. Ben-Dov,Iris Lavon +6 more
TL;DR: Specific miRNA signatures in whole blood of patients with NMO might serve as biomarkers for therapy response, and monitoring the levels of brain-specific/enriched miRNAs in the blood might reflect the degree of disease activity in the CNS of inflammatory demyelinating disorders.
Journal ArticleDOI
Neuromyelitis optica: not a multiple sclerosis variant.
Michael Barnett,Ian Sutton +1 more
TL;DR: NMO-IgG positive NMO is not an MS variant and further work is required to delineate the pathogenesis of NMO syndromes without antibodies to AQP4, and emerging concepts of molecular immunopathogenesis in NMO that can inform the development of targeted therapies.
References
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Journal ArticleDOI
A serum autoantibody marker of neuromyelitis optica : distinction from multiple sclerosis
Vanda A. Lennon,Dean M. Wingerchuk,Thomas J. Kryzer,Sean J. Pittock,C. F. Lucchinetti,Kazuo Fujihara,Ichiro Nakashima,Brian G. Weinshenker +7 more
TL;DR: NMO-IgG is a specific marker autoantibody of neuromyelitis optica and binds at or near the blood-brain barrier that distinguishes neuromyleitis opticas from multiple sclerosis.
Journal ArticleDOI
IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel.
TL;DR: It is shown that NMO-IgG binds selectively to the aquaporin-4 water channel, a component of the dystroglycan protein complex located in astrocytic foot processes at the blood-brain barrier, which may represent the first example of a novel class of autoimmune channelopathy.
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International consensus diagnostic criteria for neuromyelitis optica spectrum disorders
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