Clinical spectrum and prognostic value of CNS MOG autoimmunity in adults: The MOGADOR study - Archive ouverte du site Alsace
Article Dans Une Revue Neurology Année : 2018

Clinical spectrum and prognostic value of CNS MOG autoimmunity in adults: The MOGADOR study

1 Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL]
2 CRNL - Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center
3 CRNL-GenCyTi - Plateforme de Neurobiologie Moléculaire, Cellulaire et Tissulaire
4 CHU Pitié-Salpêtrière [AP-HP]
5 CRMBM - Centre de résonance magnétique biologique et médicale
6 Neurologie, maladies neuro-musculaires [Hôpital de la Timone - APHM]
7 LIRIC - Lille Inflammation Research International Center - U 995
8 CHU Rouen
9 Hôpital de Hautepierre [Strasbourg]
10 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
11 RMN et optique : De la mesure au biomarqueur
12 Département de Neuroradiologie [Centre Hospitalier Lyon Sud - HCL]
13 HCL - Hospices Civils de Lyon
14 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
15 CHU Nice - Centre Hospitalier Universitaire de Nice
16 Service de Médecine Nucléaire - Pierre-Paul Riquet [CHU Toulouse]
17 Département de neurologie [Montpellier]
18 CHU Montpellier = Montpellier University Hospital
19 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
20 IGF - Institut de Génomique Fonctionnelle
21 U1215 Inserm - UB - Neurocentre Magendie : Physiopathologie de la Plasticité Neuronale
22 Service de Neurologie générale, vasculaire et dégénérative (CHU de Dijon)
23 CHU Reims - Hôpital universitaire Robert Debré [Reims]
24 UNS UFR Médecine - Université Nice Sophia Antipolis - Faculté de Médecine
25 CHU Limoges
26 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
27 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
28 CIC - Centre d'investigation clinique [Nancy]
29 Service de Neurologie [Rennes] = Neurology [Rennes]
30 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
31 Centre d’Investigation Clinique Plurithématique (CIC - P) - CIC Strasbourg
Elisabeth Maillart
Jonathan Ciron
Nicolas Collongues
Caroline Papeix
David A. Laplaud
Mikael Cohen
Xavier Ayrignac
Ayman Tourbah
  • Fonction : Auteur
  • PersonId : 956692
Guillaume Mathey
Fabien Rollot
Jérôme de Sèze

Résumé

Objective To describe clinical and radiologic features associated with myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) in a large French nationwide adult cohort, to assess baseline prognostic features of MOG-Ab-associated diseases after a first acute demyelinating syndrome, and to evaluate the clinical value of MOG-Ab longitudinal analysis. Methods Clinical data were obtained from 197 MOG-Ab-positive patients ≥18 years of age. Complete imaging data were available in 108, and 54 serum samples were eligible for longitudinal evaluation. For survival analysis comparison, 169 aquaporin-4 antibody (AQP4-Ab)-positive patients from the NOMADMUS database were included. Results Median age at onset was 36.46 (range 18.0–76.8) years, and patients were predominantly white (92.9%) with male:female ratio, 1.1. Clinical phenotype at onset included optic neuritis or myelitis in 90.86%, isolated brainstem or encephalopathy syndromes in 6.6%, and a combination of syndromes in 2.5%. Distinctive brain MRI findings in MOG-Ab-positive patients were thalamic and pontine lesions. Cortical and leptomeningeal lesions were found in 16.3% and 6.1%, respectively. The probability of reaching a first relapse after 2 and 5 years was 44.8% and 61.8%, respectively. MOG-Ab-positive patients were at lower risk at presentation of further clinical relapse (hazard ratio [HR] 0.45, 95% confidence interval [CI] 0.26–0.79) compared to AQP4-Ab-positive individuals. MOG-Ab-positive individuals had a lower risk of reaching Disability Status Scale score of 3.0 (HR 0.46, 95% CI 0.22–0.94) and visual acuity of 20/100 (HR 0.23, 95% CI 0.07–0.72). Finally, MOG-Ab titers were higher at relapse than in remission (p = 0.009). Conclusion In adults, MOG-Ab-associated disease extends beyond clinical and radiologic abnormalities in the optic nerve and spinal cord. Despite the relapsing course, the overall visual and motor outcome is better compared with AQP4-Ab-positive patients.

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hal-01919569 , version 1 (03-12-2024)

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Alvaro Cobo-Calvo, Anne Ruiz, Elisabeth Maillart, Bertrand Audoin, Hélène Zéphir, et al.. Clinical spectrum and prognostic value of CNS MOG autoimmunity in adults: The MOGADOR study. Neurology, 2018, 90 (21), pp.e1858-e1869. ⟨10.1212/WNL.0000000000005560⟩. ⟨hal-01919569⟩
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