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Myelin oligodendrocyte glycoprotein antibody-associated demyelination: comparison between onset phenotypes

Zhou, Y., Jia, X., Yang, H., Chen, C., Sun, X., Peng, L., Kermode, A.G. and Qiu, W. (2018) Myelin oligodendrocyte glycoprotein antibody-associated demyelination: comparison between onset phenotypes. European Journal of Neurology, 26 (1). pp. 175-183.

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Background and purpose

The aim of this study was to analyse the clinical and prognostic features of myelin oligodendrocyte glycoprotein (MOG) antibody‐associated demyelination with different onset phenotypes.


A total of 52 MOG‐IgG‐seropositive patients were divided into four groups: (i) optic neuritis (ON) at onset (MOG‐ON+, n = 23), (ii) transverse myelitis (TM) at onset (MOG‐TM+, n = 12), (iii) pure brain symptoms at onset (MOG‐ON−‐TM−, n = 14) and (iv) both ON and TM at onset (n = 3). This final group was not included in further analyses. Data were collected through medical records and regular follow‐up.


Median age at presentation was 24 (range, 3–63) years in the whole cohort (50% female). MOG‐ON−‐TM− patients had the youngest age of onset across the three groups. Patients with MOG‐TM+ tended to relapse more frequently and had a longer interval to first relapse than was observed in MOG‐ON+ and MOG‐ON−‐TM− patients. High MOG‐IgG titres were associated with increased cerebrospinal fluid leukocytes. The likelihood of harbouring transient, low MOG‐IgG titres was higher in the MOG‐TM+ group than in the other groups. After a median disease duration of 20 months, most but not all cases had a favourable outcome, with 8% developing severe visual deficit, 2% becoming wheelchair‐dependent and 6% developing cognitive impairment. The onset phenotype appeared to be an important predictor of disability type. Having high MOG‐IgG titres (odds ratio, 0.168, P = 0.027) or female gender (odds ratio, 0.270, P = 0.067) was associated with a lower likelihood of complete recovery.


Onset phenotype may influence long‐term presentation, MOG‐IgG status as well as outcome. Further large and prospective studies are needed to better clarify the clinical implications of the first demyelinating event.

Item Type: Journal Article
Murdoch Affiliation(s): Institute for Immunology and Infectious Diseases
Publisher: Wiley
Copyright: © 2018 EAN
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