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Tajfirouz D, Madhavan A, Pacheco Marrero JM, Krecke KN, Fautsch KJ, Flanagan EP, Pittock SJ, Shah S, Bhatti MT, Chen JJ. Frequency of Asymptomatic Optic Nerve Enhancement in 203 Patients With MOG Antibody-Associated Disease. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2024; 11:e200277. [PMID: 38924706 PMCID: PMC11216805 DOI: 10.1212/nxi.0000000000200277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 05/20/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND AND OBJECTIVES Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a distinct CNS demyelinating disease. The rate of asymptomatic optic nerve enhancement on MRI has not been explored in patients with MOGAD. An improved understanding of this would guide clinical practice and assessment of treatment efficacy. We aimed to determine the frequency of asymptomatic optic nerve enhancement in MOGAD. METHODS This was a retrospective review of patients evaluated at Mayo Clinic with MOGAD between January 1, 2000, and August 1, 2021 (median follow-up 1.6 [range 1-19] years). MRI studies were reviewed by masked neuroradiologists. Scans performed within 30 days of ON attack were classified as attack scans. Images obtained for routine surveillance, before ON attack, or at the time of non-ON attack were classified as interattack scans. RESULTS Five hundred sixty-six MRIs (203 unique patients, 53% female) were included. Interattack MRIs represented 341 (60%) of the scans (median 36 days post-ON [range -1,032 to 6,001]). Of the interattack scans, 43 of 341 (13%), 30 unique patients, showed optic nerve enhancement. The enhancement was located at prior sites of ON in 35 of 43 (81%). Among the 8 patients with enhancement in new optic nerve areas, 6 had acute disseminated encephalomyelitis without an eye examination at the time of the MRI and 2 had preceding ON without imaging. Long-term visual outcomes showed no significant difference between those with and without asymptomatic enhancement, with improved visual acuity in most patients. DISCUSSION Asymptomatic optic nerve enhancement occurred in 13% of interattack MRIs, the majority in patients with prior ON and occurring at prior sites of optic nerve enhancement. New asymptomatic optic nerve enhancement in areas without prior ON was rare. These findings are important for understanding the natural history of MOGAD, the interpretation of symptoms or response to treatment, and the adjudication of attacks in clinical trials.
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Affiliation(s)
- Deena Tajfirouz
- From the Department of Ophthalmology and Neurology (D.T.), Mayo Clinic; Department of Radiology (A.M., K.N.K.); Department of Ophthalmology (J.M.P.M., K.J.F.), Mayo Clinic; Department of Neurology (E.P.F.); Department of Neurology (S.J.P.), Center for MS and Autoimmune Neurology, Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Vanderbilt University Medical Center, Nashville, TN; The Permanente Medical Group, Department of Ophthalmology (M.T.B.), Kaiser Permanente-Northern California, Roseville, CA; and Department of Neurology and Ophthalmology (J.J.C.), Mayo Clinic, Rochester, MN
| | - Ajay Madhavan
- From the Department of Ophthalmology and Neurology (D.T.), Mayo Clinic; Department of Radiology (A.M., K.N.K.); Department of Ophthalmology (J.M.P.M., K.J.F.), Mayo Clinic; Department of Neurology (E.P.F.); Department of Neurology (S.J.P.), Center for MS and Autoimmune Neurology, Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Vanderbilt University Medical Center, Nashville, TN; The Permanente Medical Group, Department of Ophthalmology (M.T.B.), Kaiser Permanente-Northern California, Roseville, CA; and Department of Neurology and Ophthalmology (J.J.C.), Mayo Clinic, Rochester, MN
| | - Johann M Pacheco Marrero
- From the Department of Ophthalmology and Neurology (D.T.), Mayo Clinic; Department of Radiology (A.M., K.N.K.); Department of Ophthalmology (J.M.P.M., K.J.F.), Mayo Clinic; Department of Neurology (E.P.F.); Department of Neurology (S.J.P.), Center for MS and Autoimmune Neurology, Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Vanderbilt University Medical Center, Nashville, TN; The Permanente Medical Group, Department of Ophthalmology (M.T.B.), Kaiser Permanente-Northern California, Roseville, CA; and Department of Neurology and Ophthalmology (J.J.C.), Mayo Clinic, Rochester, MN
| | - Karl N Krecke
- From the Department of Ophthalmology and Neurology (D.T.), Mayo Clinic; Department of Radiology (A.M., K.N.K.); Department of Ophthalmology (J.M.P.M., K.J.F.), Mayo Clinic; Department of Neurology (E.P.F.); Department of Neurology (S.J.P.), Center for MS and Autoimmune Neurology, Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Vanderbilt University Medical Center, Nashville, TN; The Permanente Medical Group, Department of Ophthalmology (M.T.B.), Kaiser Permanente-Northern California, Roseville, CA; and Department of Neurology and Ophthalmology (J.J.C.), Mayo Clinic, Rochester, MN
| | - Kalli J Fautsch
- From the Department of Ophthalmology and Neurology (D.T.), Mayo Clinic; Department of Radiology (A.M., K.N.K.); Department of Ophthalmology (J.M.P.M., K.J.F.), Mayo Clinic; Department of Neurology (E.P.F.); Department of Neurology (S.J.P.), Center for MS and Autoimmune Neurology, Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Vanderbilt University Medical Center, Nashville, TN; The Permanente Medical Group, Department of Ophthalmology (M.T.B.), Kaiser Permanente-Northern California, Roseville, CA; and Department of Neurology and Ophthalmology (J.J.C.), Mayo Clinic, Rochester, MN
| | - Eoin P Flanagan
- From the Department of Ophthalmology and Neurology (D.T.), Mayo Clinic; Department of Radiology (A.M., K.N.K.); Department of Ophthalmology (J.M.P.M., K.J.F.), Mayo Clinic; Department of Neurology (E.P.F.); Department of Neurology (S.J.P.), Center for MS and Autoimmune Neurology, Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Vanderbilt University Medical Center, Nashville, TN; The Permanente Medical Group, Department of Ophthalmology (M.T.B.), Kaiser Permanente-Northern California, Roseville, CA; and Department of Neurology and Ophthalmology (J.J.C.), Mayo Clinic, Rochester, MN
| | - Sean J Pittock
- From the Department of Ophthalmology and Neurology (D.T.), Mayo Clinic; Department of Radiology (A.M., K.N.K.); Department of Ophthalmology (J.M.P.M., K.J.F.), Mayo Clinic; Department of Neurology (E.P.F.); Department of Neurology (S.J.P.), Center for MS and Autoimmune Neurology, Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Vanderbilt University Medical Center, Nashville, TN; The Permanente Medical Group, Department of Ophthalmology (M.T.B.), Kaiser Permanente-Northern California, Roseville, CA; and Department of Neurology and Ophthalmology (J.J.C.), Mayo Clinic, Rochester, MN
| | - Shailee Shah
- From the Department of Ophthalmology and Neurology (D.T.), Mayo Clinic; Department of Radiology (A.M., K.N.K.); Department of Ophthalmology (J.M.P.M., K.J.F.), Mayo Clinic; Department of Neurology (E.P.F.); Department of Neurology (S.J.P.), Center for MS and Autoimmune Neurology, Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Vanderbilt University Medical Center, Nashville, TN; The Permanente Medical Group, Department of Ophthalmology (M.T.B.), Kaiser Permanente-Northern California, Roseville, CA; and Department of Neurology and Ophthalmology (J.J.C.), Mayo Clinic, Rochester, MN
| | - M Tariq Bhatti
- From the Department of Ophthalmology and Neurology (D.T.), Mayo Clinic; Department of Radiology (A.M., K.N.K.); Department of Ophthalmology (J.M.P.M., K.J.F.), Mayo Clinic; Department of Neurology (E.P.F.); Department of Neurology (S.J.P.), Center for MS and Autoimmune Neurology, Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Vanderbilt University Medical Center, Nashville, TN; The Permanente Medical Group, Department of Ophthalmology (M.T.B.), Kaiser Permanente-Northern California, Roseville, CA; and Department of Neurology and Ophthalmology (J.J.C.), Mayo Clinic, Rochester, MN
| | - John J Chen
- From the Department of Ophthalmology and Neurology (D.T.), Mayo Clinic; Department of Radiology (A.M., K.N.K.); Department of Ophthalmology (J.M.P.M., K.J.F.), Mayo Clinic; Department of Neurology (E.P.F.); Department of Neurology (S.J.P.), Center for MS and Autoimmune Neurology, Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Vanderbilt University Medical Center, Nashville, TN; The Permanente Medical Group, Department of Ophthalmology (M.T.B.), Kaiser Permanente-Northern California, Roseville, CA; and Department of Neurology and Ophthalmology (J.J.C.), Mayo Clinic, Rochester, MN
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Moseley CE, Virupakshaiah A, Forsthuber TG, Steinman L, Waubant E, Zamvil SS. MOG CNS Autoimmunity and MOGAD. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2024; 11:e200275. [PMID: 38996203 PMCID: PMC11256982 DOI: 10.1212/nxi.0000000000200275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 04/30/2024] [Indexed: 07/14/2024]
Abstract
At one time considered a possible form of neuromyelitis optica (NMO) spectrum disorder (NMOSD), it is now accepted that myelin oligodendrocyte glycoprotein (MOG) antibody (Ab)-associated disorder (MOGAD) is a distinct entity from either NMO or multiple sclerosis (MS) and represents a broad spectrum of clinical phenotypes. Whereas Abs targeting aquaporin-4 (AQP4) in NMO are pathogenic, the extent that anti-MOG Abs contribute to CNS damage in MOGAD is unclear. Both AQP4-specific Abs in NMO and MOG-specific Abs in MOGAD are predominantly IgG1, a T cell-dependent immunoglobulin (Ig) subclass. Key insights in neuroimmunology and MOGAD pathogenesis have been learned from MOG experimental autoimmune encephalomyelitis (EAE), described 2 decades before the term MOGAD was introduced. MOG-specific T cells are required in MOG EAE, and while anti-MOG Abs can exacerbate EAE and CNS demyelination, those Abs are neither necessary nor sufficient to cause EAE. Knowledge regarding the spectrum of MOGAD clinical and radiologic presentations is advancing rapidly, yet our grasp of MOGAD pathogenesis is incomplete. Understanding both the humoral and cellular immunology of MOGAD has implications for diagnosis, treatment, and prognosis.
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Affiliation(s)
- Carson E Moseley
- From the Department of Neurology (C.E.M., A.V., E.W., S.S.Z.), Weill Institute for Neurosciences, University of California, San Francisco; Department of Molecular Microbiology and Immunology (T.G.F.), University of Texas at San Antonio; Department of Neurology and Neurological Science (L.S.), Stanford University; and Program in Immunology (S.S.Z.), University of California, San Francisco, CA
| | - Akash Virupakshaiah
- From the Department of Neurology (C.E.M., A.V., E.W., S.S.Z.), Weill Institute for Neurosciences, University of California, San Francisco; Department of Molecular Microbiology and Immunology (T.G.F.), University of Texas at San Antonio; Department of Neurology and Neurological Science (L.S.), Stanford University; and Program in Immunology (S.S.Z.), University of California, San Francisco, CA
| | - Thomas G Forsthuber
- From the Department of Neurology (C.E.M., A.V., E.W., S.S.Z.), Weill Institute for Neurosciences, University of California, San Francisco; Department of Molecular Microbiology and Immunology (T.G.F.), University of Texas at San Antonio; Department of Neurology and Neurological Science (L.S.), Stanford University; and Program in Immunology (S.S.Z.), University of California, San Francisco, CA
| | - Lawrence Steinman
- From the Department of Neurology (C.E.M., A.V., E.W., S.S.Z.), Weill Institute for Neurosciences, University of California, San Francisco; Department of Molecular Microbiology and Immunology (T.G.F.), University of Texas at San Antonio; Department of Neurology and Neurological Science (L.S.), Stanford University; and Program in Immunology (S.S.Z.), University of California, San Francisco, CA
| | - Emmanuelle Waubant
- From the Department of Neurology (C.E.M., A.V., E.W., S.S.Z.), Weill Institute for Neurosciences, University of California, San Francisco; Department of Molecular Microbiology and Immunology (T.G.F.), University of Texas at San Antonio; Department of Neurology and Neurological Science (L.S.), Stanford University; and Program in Immunology (S.S.Z.), University of California, San Francisco, CA
| | - Scott S Zamvil
- From the Department of Neurology (C.E.M., A.V., E.W., S.S.Z.), Weill Institute for Neurosciences, University of California, San Francisco; Department of Molecular Microbiology and Immunology (T.G.F.), University of Texas at San Antonio; Department of Neurology and Neurological Science (L.S.), Stanford University; and Program in Immunology (S.S.Z.), University of California, San Francisco, CA
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Oertel FC, Zimmermann HG, Motamedi S, Bereuter C, Manthey LM, Ashtari F, Kafieh R, Dehghani A, Pourazizi M, Pandit L, D'Cunha A, Aktas O, Albrecht P, Ringelstein M, Martinez-Lapiscina EH, Sanchez Dalmau BF, Villoslada P, Asgari N, Marignier R, Cobo-Calvo A, Leocani L, Pisa M, Radaelli M, Palace J, Roca-Fernandez A, Leite MIS, Sharma S, De Seze J, Senger T, Yeaman MR, Smith TJ, Cook LJ, Brandt AU, Paul F. Retinal Changes in Double-Antibody Seronegative Neuromyelitis Optica Spectrum Disorders. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2024; 11:e200273. [PMID: 38941573 PMCID: PMC11214151 DOI: 10.1212/nxi.0000000000200273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 05/29/2024] [Indexed: 06/30/2024]
Abstract
BACKGROUND AND OBJECTIVES To systematically describe the clinical picture of double-antibody seronegative neuromyelitis optica spectrum disorders (DN-NMOSD) with specific emphasis on retinal involvement. METHODS Cross-sectional data of 25 people with DN-NMOSD (48 eyes) with and without a history of optic neuritis (ON) were included in this study along with data from 25 people with aquaporin-4 antibody seropositive neuromyelitis optica spectrum disorder (AQP4-NMOSD, 46 eyes) and from 25 healthy controls (HCs, 49 eyes) for comparison. All groups were matched for age and sex and included from the collaborative retrospective study of retinal optical coherence tomography (OCT) in neuromyelitis optica (CROCTINO). Participants underwent OCT with central postprocessing and local neurologic examination and antibody testing. Retinal neurodegeneration was quantified as peripapillary retinal nerve fiber layer thickness (pRNFL) and combined ganglion cell and inner plexiform layer thickness (GCIPL). RESULTS This DN-NMOSD cohort had a history of [median (inter-quartile range)] 6 (5; 9) attacks within their 5 ± 4 years since onset. Myelitis and ON were the most common attack types. In DN-NMOSD eyes after ON, pRNFL (p < 0.001) and GCIPL (p = 0.023) were thinner compared with eyes of HCs. Even after only one ON episode, DN-NMOSD eyes already had considerable neuroaxonal loss compared with HCs. In DN-NMOSD eyes without a history of ON, pRNFL (p = 0.027) and GCIPL (p = 0.022) were also reduced compared with eyes of HCs. However, there was no difference in pRNFL and GCIPL between DN-NMOSD and AQP4-NMOSD for the whole group and for subsets with a history of ON and without a history of ON-as well as between variances of retinal layer thicknesses. DISCUSSION DN-NMOSD is characterized by severe retinal damage after ON and attack-independent retinal neurodegeneration. Most of the damage occurs during the first ON episode, which highlights the need for better diagnostic markers in DN-NMOSD to facilitate an earlier diagnosis as well as for effective and early treatments. In this study, people with DN-NMOSD presented with homogeneous clinical and imaging findings potentially suggesting a common retinal pathology in these patients.
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Affiliation(s)
- Frederike C Oertel
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Hanna G Zimmermann
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Seyedamirhosein Motamedi
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Charlotte Bereuter
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Luca Magdalena Manthey
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Fereshteh Ashtari
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Rahele Kafieh
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Alireza Dehghani
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Mohsen Pourazizi
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Lekha Pandit
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Anitha D'Cunha
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Orhan Aktas
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Philipp Albrecht
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Marius Ringelstein
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Elena H Martinez-Lapiscina
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Bernardo F Sanchez Dalmau
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Pablo Villoslada
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Nasrin Asgari
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Romain Marignier
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Alvaro Cobo-Calvo
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Letizia Leocani
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Marco Pisa
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Marta Radaelli
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Jacqueline Palace
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Adriana Roca-Fernandez
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Maria Isabel S Leite
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Srilakshmi Sharma
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Jerome De Seze
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Thomas Senger
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Michael R Yeaman
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Terry J Smith
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Lawrence J Cook
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Alexander U Brandt
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
| | - Friedemann Paul
- From the Experimental and Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.), Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin; Neuroscience Clinical Research Center (F.C.O., H.G.Z., S.M., C.B., L.M.M., A.U.B., F.P.); Department of Neurology (F.C.O., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Einstein Center Digital Future (H.G.Z.), Berlin, Germany; Kashani MS Center (F.A.), Isfahan University of Medical Sciences; School of Advanced Technologies in Medicine and Medical Image and Signal Processing Research Center (R.K.); Department of Ophthalmology (A.D., M. Pourazizi), Isfahan Eye Research Center, Isfahan University of Medical Sciences, Iran; Department of Neurology (L.P., A.D.C.), KS Hegde Medical Academy, Nitte University, Mangalore, India; Department of Neurology (O.A., P.A., M. Ringelstein), Medical Faculty, Heinrich Heine University Düsseldorf; Department of Neurlogy (P.A.), Kliniken Maria Hilf Mönchengladbach; Centre for Neurology and Neuropsychiatry (M. Ringelstein), Landschaftsverband Rheinland-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Germany; Hospital Clinic of Barcelona-Institut d'Investigacions (E.H.M.-L., B.F.S.D., P.V.), Biomèdiques August Pi Sunyer, (IDIBAPS), Barcelona, Spain; Departments of Neurology (N.A.), Slagelse Hospitals, Denmark, Institute of Regional Health Research; Institute of Molecular Medicine (N.A.), University of Southern Denmark, Odense, Denmark; Service de Neurologie (R.M., A.C.-C.), Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre d'Esclerosi Múltiple de Catalunya (Cemcat) (A.C.-C.), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron. Universitat Autònoma de Barcelona, Spain; Experimental Neurophysiology Unit (L.L., M. Pisa, M. Radaelli), Institute of Experimental Neurology (INSPE) Scientific Institute San Raffaele and University Vita-Salute San Raffaele, Milan, Italy; Department of Neurology (J.P., A.R.-F., M.I.S.L.); Department of Ophthalmology (S.S.), Oxford University Hospitals, National Health Service Trust, United Kingdom; Neurology Service (J.D.S., T.S.), University Hospital of Strasbourg, France; Department of Medicine (M.R.Y.), Divisions of Molecular Medicine and Infectious Diseases, Harbor-University of California at Los Angeles (UCLA) Medical Center, and Lundquist Institute for Biomedical Innovation, Torrance; Department of Medicine (M.R.Y.), David Geffen School of Medicine at UCLA, Los Angeles; Departments of Ophthalmology and Visual Sciences (T.J.S.), Kellogg Eye Center; Division of Metabolism (T.J.S.), Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor; and Department of Pediatrics (L.J.C.), University of Utah
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Cabrera-Maqueda JM, Sepulveda M, García RR, Muñoz-Sánchez G, Martínez-Cibrian N, Ortíz-Maldonado V, Lorca-Arce D, Guasp M, Llufriu S, Martinez-Hernandez E, Armangue T, Fonseca EG, Alba-Isasi MT, Delgado J, Dalmau J, Juan M, Saiz A, Blanco Y. CD19-Directed CAR T-Cells in a Patient With Refractory MOGAD: Clinical and Immunologic Follow-Up for 1 Year. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2024; 11:e200292. [PMID: 39106426 PMCID: PMC11309560 DOI: 10.1212/nxi.0000000000200292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/10/2024] [Indexed: 08/09/2024]
Abstract
OBJECTIVES In MOG antibody-associated disease (MOGAD), relapse prevention and the treatment approach to refractory symptoms are unknown. We report a patient with refractory MOGAD treated with CD19-directed CAR T-cells. METHODS CD19-directed CAR T-cells (ARI-0001) were produced in-house by lentiviral transduction of autologous fresh leukapheresis and infused after a conventional lymphodepleting regimen. RESULTS A 18-year-old man developed 2 episodes of myelitis associated with serum MOG-IgG, which were followed by 6 episodes of left optic neuritis (ON) and sustained the presence of MOG-IgG over 6 years despite multiple immunotherapies. After the sixth episode of ON, accompanied by severe residual visual deficits, CAR T-cell treatment was provided without complications. Follow-up of cell counts showed complete depletion of CD19+ B cells at day +7; reconstituted B cells at day +141 showing a naïve B-cell phenotype, and low or absent memory B cells and plasmablasts for 1 year. MOG-IgG titers have remained undetectable since CAR T-cell infusion. The patient had an early episode of left ON at day +29, when MOG-IgG was already negative, and since then he has remained free of relapses without immunotherapy for 1 year. DISCUSSION This clinical case shows that CD19-directed CAR T-cell therapy is well-tolerated and is a potential treatment for patients with refractory MOGAD. CLASSIFICATION OF EVIDENCE This provides Class IV evidence. It is a single observational study without controls.
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Affiliation(s)
- Jose Maria Cabrera-Maqueda
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Maria Sepulveda
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Raquel Ruiz García
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Guillermo Muñoz-Sánchez
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Nuria Martínez-Cibrian
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Valentín Ortíz-Maldonado
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Daniel Lorca-Arce
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Mar Guasp
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Sara Llufriu
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Eugenia Martinez-Hernandez
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Thais Armangue
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Elianet G Fonseca
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - María Teresa Alba-Isasi
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Julio Delgado
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Josep Dalmau
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Manel Juan
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Albert Saiz
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
| | - Yolanda Blanco
- From the Neuroimmunology and Multiple Sclerosis Unit (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., A.S., Y.B.), Service of Neurology, Hospital Clinic de Barcelona, and Universitat de Barcelona; Neuroimmunology Program (J.M.C.-M., M.S., R.R.G., M.G., S.L., E.M.-H., T.A., E.G.F., M.T.A.-I., J.D., A.S., Y.B.), Fundació de Recerca Clínic Barcelona- Institut d'Investigacions Biomèdiques August Pi i Sunyer; Department of Immunology (R.R.G., G.M.-S., D.L.-A., M.J.), Hospital Clínic de Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona; Department of Hematology (N.M.-C., V.O.-M., J.D.), Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Pediatric Neuroimmunology Unit (T.A.), Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) (J.D.); University of Barcelona; Caixa Research Institute (J.D.), Barcelona; and Joint Platform for Immunotherapy of Sant Joan de Deu - Hospital Clinic de Barcelona (M.J.), Spain
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Karalius M, Mohan S, Paredes D, Rasool N, Bove R. Pearls & Oy-sters: Optic Neuritis as First Demyelinating Event During Pregnancy in 2 Young Hispanic Women: MS vs MOGAD. Neurology 2024; 103:e209706. [PMID: 39052965 DOI: 10.1212/wnl.0000000000209706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024] Open
Abstract
Optic neuritis (ON) can present as the first demyelinating attack in both multiple sclerosis (MS) and myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD), which may require different treatment depending on the final diagnosis. We present 2 young Hispanic women who presented with ON during pregnancy, one of whom was diagnosed with MS and the other with MOGAD. We describe key clinical features to help differentiate between MS and MOGAD including ON features, brain and spinal MRI, CSF profiles, and serum MOG and aquaporin-4 (AQP-4) antibodies, which all can help guide clinicians to an ultimate diagnosis. Pregnancy is usually considered an immunotolerant state because complex immunologic shifts arising to support tolerance of the developing fetus seem to decrease the risk of relapses. However, relapses may still occur during pregnancy, and relapse rates increase immediately postpartum. Our cases raise the possibility that young Hispanic patients may face increased risk of demyelinating disease activity even during the relatively immunotolerant state of pregnancy. A high index of suspicion for demyelinating disease should be maintained to accelerate diagnosis and prevent disability.
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Affiliation(s)
- Mary Karalius
- From the UCSF Weill Institute for Neurosciences (M.K., S.M., D.P., R.B.), Department of Neurology, University of California; and Department of Ophthalmology (N.R.), University of California, San Francisco
| | - Sonam Mohan
- From the UCSF Weill Institute for Neurosciences (M.K., S.M., D.P., R.B.), Department of Neurology, University of California; and Department of Ophthalmology (N.R.), University of California, San Francisco
| | - Danelvis Paredes
- From the UCSF Weill Institute for Neurosciences (M.K., S.M., D.P., R.B.), Department of Neurology, University of California; and Department of Ophthalmology (N.R.), University of California, San Francisco
| | - Nailyn Rasool
- From the UCSF Weill Institute for Neurosciences (M.K., S.M., D.P., R.B.), Department of Neurology, University of California; and Department of Ophthalmology (N.R.), University of California, San Francisco
| | - Riley Bove
- From the UCSF Weill Institute for Neurosciences (M.K., S.M., D.P., R.B.), Department of Neurology, University of California; and Department of Ophthalmology (N.R.), University of California, San Francisco
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6
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Deschamps R, Guillaume J, Ciron J, Audoin B, Ruet A, Maillart E, Pique J, Benyahya L, Laplaud DA, Michel L, Collongues N, Cohen M, Ayrignac X, Thouvenot E, Zephir H, Bourre B, Froment Tilikete C, Moreau T, Cantagrel P, Kerschen P, Cabasson S, Maubeuge N, Hankiewicz K, Nifle C, Berger E, Megherbi H, Magy L, Klapczynski F, Sarov Riviere M, Giannesini C, Hamelin L, Giroux M, Branger P, Maurousset A, Mathey G, Moulin M, Mélé N, Papeix C, Marignier R. Early Maintenance Treatment Initiation and Relapse Risk Mitigation After a First Event of MOGAD in Adults: The MOGADOR2 Study. Neurology 2024; 103:e209624. [PMID: 38991174 DOI: 10.1212/wnl.0000000000209624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Because myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a recently identified autoimmune disorder, the natural history of MOGAD is still not well described. The objective of this study was to describe the long-term outcomes of adult patients with MOGAD. In addition, we aimed to identify factors affecting relapse risk and neurologic outcomes. METHODS Clinical and biological data were obtained from patients with a first event of MOGAD and included in the French nationwide incident cohort between February 2014 and March 2017. Only patients aged 18 years or older at disease onset and with observation period of at least 3 months were included. Data were collected prospectively until July 2023 and registered in the dedicated French nationwide database. This form includes every relapse with phenotype description during follow-up, date of last assessment, final clinical outcome with Expanded Disability Status Scale score and visual acuity, and maintenance therapy. The probability of recurrence-free survival was assessed using the Kaplan-Meier method. RESULTS We included 128 patients. The onset phenotype was isolated optic neuritis in 81 patients (63.3%) and isolated myelitis in 25 patients (19.5%). The median follow-up duration was 77.8 months (range 3.2-111.2), with 49 patients (38.3%) experienced at least one relapse. Median times from onset to second and third attacks were 3.2 (1.0-86.2) and 13.0 (2.6-64.4) months, respectively. At the last assessment, Expanded Disability Status Scale Score was ≥3 and ≥6 in 22 (17.2%) and 6 (4.7%) patients, respectively. Eighty patients received at least one maintenance treatment. This treatment was initiated after the first attack in 47 patients (36.7% of the whole cohort) and at the time of a second attack in 25 (19.5%). Multivariate analysis revealed that initiating maintenance treatment after the first attack was associated with a lower relapse risk (OR = 0.26 [95% CI 0.11-0.62], p = 0.002). In patients receiving maintenance therapy after first attack, the 2-year, 4-year, 6-year, and 8-year relapse risks were 11%, 15%, 20%, and 20%, respectively. In other patients, the risks were 41%, 46%, 51%, and 56%. DISCUSSION The highest risk of a relapse in MOGAD occurs early, and initiating maintenance therapy from the first attack substantially reduced the relapse risk. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that initiating maintenance therapy from the first attack in patients with MOGAD reduces the relapse risk.
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Affiliation(s)
- Romain Deschamps
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Jessica Guillaume
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Jonathan Ciron
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Bertrand Audoin
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Aurélie Ruet
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Elisabeth Maillart
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Julie Pique
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Lakhdar Benyahya
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - David A Laplaud
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Laure Michel
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Nicolas Collongues
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Mikael Cohen
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Xavier Ayrignac
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Eric Thouvenot
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Helene Zephir
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Bertrand Bourre
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Caroline Froment Tilikete
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Thibault Moreau
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Paul Cantagrel
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Philippe Kerschen
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Sebastien Cabasson
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Nicolas Maubeuge
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Karolina Hankiewicz
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Chantal Nifle
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Eric Berger
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Hana Megherbi
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Laurent Magy
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Frederic Klapczynski
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Mariana Sarov Riviere
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Claire Giannesini
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Lorraine Hamelin
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Marianne Giroux
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Pierre Branger
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Aude Maurousset
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Guillaume Mathey
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Maximilien Moulin
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Nicolas Mélé
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Caroline Papeix
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
| | - Romain Marignier
- From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone; Department of Neurology (A.R.), University Hospital of Bordeaux; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (E.M., C.G.), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris; Centre de référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM) (J.P., L.B., R.M.), Department of Neurology, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hôpital Neurologique Pierre Wertheimer; Department of Neurology (D.A.L.), CR2TI-Inserm U1064, CIC1314, Nantes Université, University Hospital of Nantes; Department of Neurology (L. Michel), INSERM UMR 1236, Université de Rennes 1, University Hospital of Rennes, Rennes, France; Center for Clinical Investigation (N.C.), INSERM U1434; Biopathology of Myelin, Neuroprotection and Therapeutic Strategy, INSERM U1119; Department of Neurology, University Hospital of Strasbourg; CRC SEP Neurologie Pasteur 2 (M.C.), University Hospital of Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice; CRC SEP (X.A.), CRMR Leukofrance, Department of Neurology, INM / U1298, Gui de Chauliac Hospital, University Hospital of Montpellier; Department of Neurology (E.T.), University Hospital of Nimes; CRC SEP (H.Z.), Department of Neurology, U 1172, University Hospital of Lille; Department of Neurology (B.B.), University Hospital of Rouen; Neuro Ophthalmology Unit (C.F.T.), Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon Neuroscience Research Center CRNL U1028 UMR 5292, IMPACT F-69500, Neurological Hospital of Lyon; Department of Neurology (T.M.), University Hospital of Dijon; Department of Neurology (P.C.), University Hospital of la Rochelle; Department of Neurology (P.K.), Hospital of Luxembourg, Luxembourg-Ville, Luxembourg; Department of Child Neurology and Child Intensive Care Unit (S.C.), Hospital of Pau; Department of Neurology (N. Maubeuge), University Hospital of Poitiers; Department of Neurology (K.H.), Delafontaine Hospital, Saint-Denis; Department of Neurology (C.N.), Andre Mignot hospital, Hospital of Versailles, Le Chesnay; Department of Neurology (E.B.), University Hospital of Besancon; Department of Neurology (H.M.), Sud Francilien Hospital, Corbeil-Essonnes; CRC SEP Limoges/Poitiers (L. Magy), CRMR Maladies Neuromusculaires AOC (FILNEMUS), UR 2018 NeurIT, University Hospital of Limoges; Department of Neurology (F.K.), Meaux Hospital; Department of Neurology (M.S.R.), University Hospital of Bicêtre, Le Kremlin-Bicêtre; Department of Neurology (L.H.), Felix Guyon University Hospital, Saint Denis, Reunion; Department of Neurology (M.G.), Hospital of Valenciennes; Department of Neurology (P.B.), University Hospital of Caen Normandie; CRC SEP (A.M.), Department of Neurology, University Hospital of Tours, Bretonneau Hospital; Department of Neurology (G.M.), Nancy University Hospital; Université de Lorraine, EA 4360 APEMAC, Vandoeuvre-Lès-Nancy; Department of Neurology (M.M.), University Hospital of Reims; Department of Neurology (N. Mélé), Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris Cité University, INSERM 1266; and Department of Neurology (C.P.), Rothschild Foundation Hospital, Paris, France
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7
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Klyscz P, Asseyer S, Alonso R, Bereuter C, Bialer O, Bick A, Carta S, Chen JJ, Cohen L, Cohen-Tayar Y, Contentti EC, Dale RC, Flanagan EP, Gernert JA, Haas J, Havla J, Heesen C, Hellmann M, Levin N, Lopez P, Lotan I, Luis MB, Mariotto S, Mayer C, Vergara AJM, Ocampo C, Ochoa S, Oertel FC, Olszewska M, Uribe JLP, Sastre-Garriga J, Scocco D, Ramanathan S, Rattanathamsakul N, Shi FD, Shifa J, Simantov I, Siritho S, Tiosano A, Tisavipat N, Torres I, Dembinsky AV, Vidal-Jordana A, Wilf-Yarkoni A, Wu T, Zamir S, Zarco LA, Zimmermann HG, Petzold A, Paul F, Stiebel-Kalish H. Application of the international criteria for optic neuritis in the Acute Optic Neuritis Network. Ann Clin Transl Neurol 2024. [PMID: 39099240 DOI: 10.1002/acn3.52166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 07/03/2024] [Accepted: 07/16/2024] [Indexed: 08/06/2024] Open
Abstract
OBJECTIVE The first international consensus criteria for optic neuritis (ICON) were published in 2022. We applied these criteria to a prospective, global observational study of acute optic neuritis (ON). METHODS We included 160 patients with a first-ever acute ON suggestive of a demyelinating CNS disease from the Acute Optic Neuritis Network (ACON). We applied the 2022 ICON to all participants and subsequently adjusted the ICON by replacing a missing relative afferent pupillary defect (RAPD) or dyschromatopsia if magnetic resonance imaging pathology of the optical nerve plus optical coherence tomography abnormalities or certain biomarkers are present. RESULTS According to the 2022 ICON, 80 (50%) patients were classified as definite ON, 12 (7%) patients were classified as possible ON, and 68 (43%) as not ON (NON). The main reasons for classification as NON were absent RAPD (52 patients, 76%) or dyschromatopsia (49 patients, 72%). Distribution of underlying ON etiologies was as follows: 78 (49%) patients had a single isolated ON, 41 (26%) patients were diagnosed with multiple sclerosis, 25 (16%) patients with myelin oligodendrocyte glycoprotein antibody-associated disease, and 15 (9%) with neuromyelitis optica spectrum disorder. The application of the adjusted ON criteria yielded a higher proportion of patients classified as ON (126 patients, 79%). INTERPRETATION According to the 2022 ICON, almost half of the included patients in ACON did not fulfill the requirements for classification of definite or possible ON, particularly due to missing RAPD and dyschromatopsia. Thorough RAPD examination and formal color vision testing are critical to the application of the 2022 ICON.
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Affiliation(s)
- Philipp Klyscz
- Experimental and Clinical Research Center, A Cooperation between Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin, Berlin, Germany
- Department of Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
- Neuroscience Clinical Research Center (NCRC), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Susanna Asseyer
- Experimental and Clinical Research Center, A Cooperation between Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin, Berlin, Germany
- Department of Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
- Neuroscience Clinical Research Center (NCRC), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ricardo Alonso
- University Center of MS and NMOSD, Neurology Department, Ramos Mejia Hospital, Buenos Aires, Argentina
| | - Charlotte Bereuter
- Experimental and Clinical Research Center, A Cooperation between Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin, Berlin, Germany
- Neuroscience Clinical Research Center (NCRC), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Omer Bialer
- Department of Neuro-Ophthalmology, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Atira Bick
- Department of Neurology, Hadassah Medical Center, Hebrew University, Jerusalem, Israel
| | - Sara Carta
- Neurology Unit, Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
| | - John J Chen
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Center for MS and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA
| | - Leila Cohen
- University Center of MS and NMOSD, Neurology Department, Ramos Mejia Hospital, Buenos Aires, Argentina
| | - Yamit Cohen-Tayar
- Department of Neuro-Ophthalmology, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Eye Laboratory, Felsenstein Medical Research Center, Tel Aviv University, Tel Aviv, Israel
| | | | - Russell C Dale
- TY Nelson Department of Paediatric Neurology, Children's Hospital at Westmead, Sydney, New South Wales, Australia
- Faculty of Medicine and Health and Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
- Clinical Neuroimmunology Group, Kids Neuroscience Centre, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Eoin P Flanagan
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Center for MS and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Jonathan A Gernert
- Institute of Clinical Neuroimmunology, LMU Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Julian Haas
- Experimental and Clinical Research Center, A Cooperation between Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
- Neuroscience Clinical Research Center (NCRC), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Joachim Havla
- Institute of Clinical Neuroimmunology, LMU Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Christoph Heesen
- Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Mark Hellmann
- Department of Neuro-Ophthalmology, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Netta Levin
- Department of Neurology, Hadassah Medical Center, Hebrew University, Jerusalem, Israel
| | - Pablo Lopez
- Neuroimmunology Unit, Department of Neuroscience, Hospital Aleman, Buenos Aires, Argentina
| | - Itay Lotan
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Neuroimmunology Service, Department of Neurology, Rabin Medical Center, Petah Tikva, Israel
- Neuromyelitis Optica Research Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Maria Belen Luis
- University Center of MS and NMOSD, Neurology Department, Ramos Mejia Hospital, Buenos Aires, Argentina
| | - Sara Mariotto
- Neurology Unit, Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
| | - Christina Mayer
- Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | | | | | - Susana Ochoa
- University Center of MS and NMOSD, Neurology Department, Ramos Mejia Hospital, Buenos Aires, Argentina
| | - Frederike C Oertel
- Experimental and Clinical Research Center, A Cooperation between Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin, Berlin, Germany
- Department of Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Neuroscience Clinical Research Center (NCRC), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Maja Olszewska
- Neuroscience Clinical Research Center (NCRC), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Jaume Sastre-Garriga
- Neurology Department, Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d'Hebron University Hospital, Barcelona, Spain
| | - Dario Scocco
- University Center of MS and NMOSD, Neurology Department, Ramos Mejia Hospital, Buenos Aires, Argentina
| | - Sudarshini Ramanathan
- Faculty of Medicine and Health and Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
- Department of Neurology, Concord Hospital, Sydney, New South Wales, Australia
- Translational Neuroimmunology Group, Kids Neuroscience Centre, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | | | - Fu-Dong Shi
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jemal Shifa
- Department of Surgery, University of Botswana, Gaborone, Botswana
| | - Ilya Simantov
- Department of Neuro-Ophthalmology, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Eye Laboratory, Felsenstein Medical Research Center, Tel Aviv University, Tel Aviv, Israel
| | - Sasitorn Siritho
- Faculty of Medicine Siriraj Hospital, Mahidol University Bangkok, Bangkok, Thailand
- Neuroscience Center, Bumrungrad International Hospital, Bangkok, Thailand
| | - Alon Tiosano
- Department of Neuro-Ophthalmology, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nanthaya Tisavipat
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Center for MS and Autoimmune Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Isabel Torres
- Pontificia Universidad Javeriana and Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Adi Vaknin Dembinsky
- Department of Neurology, Hadassah Medical Center, Hebrew University, Jerusalem, Israel
| | - Angela Vidal-Jordana
- Neurology Department, Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d'Hebron University Hospital, Barcelona, Spain
| | - Adi Wilf-Yarkoni
- Neuroimmunology Service, Department of Neurology, Rabin Medical Center, Petah Tikva, Israel
- Department of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ti Wu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Sol Zamir
- Department of Neurology, Hadassah Medical Center, Hebrew University, Jerusalem, Israel
| | - Luis Alfonso Zarco
- Pontificia Universidad Javeriana and Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Hanna G Zimmermann
- Experimental and Clinical Research Center, A Cooperation between Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
- Einstein Center Digital Future, Berlin, Germany
| | - Axel Petzold
- The National Hospital for Neurology and Neurosurgery, University College London, London, UK
- Moorfields Eye Hospital, London, UK
- Neuro-ophthalmology Expert Centre, Amsterdam, Netherlands
| | - Friedemann Paul
- Experimental and Clinical Research Center, A Cooperation between Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin, Berlin, Germany
- Department of Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
- Neuroscience Clinical Research Center (NCRC), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Hadas Stiebel-Kalish
- Department of Neuro-Ophthalmology, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Eye Laboratory, Felsenstein Medical Research Center, Tel Aviv University, Tel Aviv, Israel
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de Medeiros Rimkus C, Fragoso DC, Apóstolos Pereira SL, da Costa Leite C. Atypical Demyelinating Disorders: MR Imaging Features, Atypical Triggers, and Etiopathogenesis. Neuroimaging Clin N Am 2024; 34:421-438. [PMID: 38942525 DOI: 10.1016/j.nic.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024]
Abstract
Atypical demyelinating lesions (ADLs) can be idiopathic, occurring as isolated and self-limited events, or can appear in different stages of relapsing demyelinating diseases. Not infrequently, ADLs occur in inflammatory syndromes associated with exogenous or endogenous toxic factors, metabolic imbalance, or infectious agents. It is important to recognize imaging patterns that indicate an inflammatory/demyelinating substrate in central nervous system lesions and to investigate potential triggers or complicating factors that might be associated. The prognostic and treatment strategies of ADLs are influenced by the underlying etiopathogenesis.
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Affiliation(s)
- Carolina de Medeiros Rimkus
- Department of Radiology and Oncology, Faculdade de Medicina da Universidade de São Paulo, R. Dr. Ovídio Pires de Campos, 75, Cerqueira Cesar, São Paulo-SP, 05403-010, Brazil; Instituto D'Or de Ensino e Pesquisa (IDOR), Av. Brigadeiro Luís Antônio, 5001 - Jardim Paulista, São Paulo - SP - CEP 01401-002; MS Center, Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, De Boelelaan, 1117, 1081 HV, Amsterdam, The Netherlands.
| | - Diego Cardoso Fragoso
- Department of Radiology and Oncology, Faculdade de Medicina da Universidade de São Paulo, R. Dr. Ovídio Pires de Campos, 75, Cerqueira Cesar, São Paulo-SP, 05403-010, Brazil; Fleury Group, Av. Morumbi, 8860 - Jardim das Acacias, São Paulo - SP, 04580-060, Brazil
| | - Samira Luisa Apóstolos Pereira
- Department of Neurology, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255 - Sala 5083, 5° andar - Cerqueira César, São Paulo-SP, 05402-000, Brazil
| | - Claudia da Costa Leite
- Department of Radiology and Oncology, Faculdade de Medicina da Universidade de São Paulo, R. Dr. Ovídio Pires de Campos, 75, Cerqueira Cesar, São Paulo-SP, 05403-010, Brazil; Fleury Group, Av. Morumbi, 8860 - Jardim das Acacias, São Paulo - SP, 04580-060, Brazil
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Stefan KA, Ciotti JR. MOG Antibody Disease: Nuances in Presentation, Diagnosis, and Management. Curr Neurol Neurosci Rep 2024; 24:219-232. [PMID: 38805147 DOI: 10.1007/s11910-024-01344-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE OF REVIEW Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) is a distinct neuroinflammatory condition characterized by attacks of optic neuritis, transverse myelitis, and other demyelinating events. Though it can mimic multiple sclerosis and neuromyelitis optica spectrum disorder, distinct clinical and radiologic features which can discriminate these conditions are now recognized. This review highlights recent advances in our understanding of clinical manifestations, diagnosis, and treatment of MOGAD. RECENT FINDINGS Studies have identified subtleties of common clinical attacks and identified more rare phenotypes, including cerebral cortical encephalitis, which have broadened our understanding of the clinicoradiologic spectrum of MOGAD and culminated in the recent publication of proposed diagnostic criteria with a familiar construction to those diagnosing other neuroinflammatory conditions. These criteria, in combination with advances in antibody testing, should simultaneously lead to wider recognition and reduced incidence of misdiagnosis. In addition, recent observational studies have raised new questions about when to treat MOGAD chronically, and with which agent. MOGAD pathophysiology informs some of the relatively unique clinical and radiologic features which have come to define this condition, and similarly has implications for diagnosis and management. Further prospective studies and the first clinical trials of therapeutic options will answer several remaining questions about the peculiarities of this condition.
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Affiliation(s)
- Kelsey A Stefan
- Department of Neurology, University of South Florida, 13330 USF Laurel Drive, Tampa, FL, 33612, USA
| | - John R Ciotti
- Department of Neurology, University of South Florida, 13330 USF Laurel Drive, Tampa, FL, 33612, USA.
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10
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McKeon A, Pittock SJ. Overview and Diagnostic Approach in Autoimmune Neurology. Continuum (Minneap Minn) 2024; 30:960-994. [PMID: 39088285 DOI: 10.1212/con.0000000000001447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2024]
Abstract
OBJECTIVE The field of autoimmune neurology is rapidly evolving. This article reviews the epidemiology and pathophysiology as well as current approaches to clinical and paraclinical assessment, testing paradigms, and general principles of treatment. LATEST DEVELOPMENTS Improved recognition of autoimmune diagnoses among patients who have phenotypically diverse, subacute onset neurologic presentations is facilitated by disease-specific antibody biomarker discovery. These antibodies have varying associations with paraneoplastic causation (from no association to greater than 70% positive predictive value), immunotherapy responses, and outcomes. To simplify assessment in an increasingly complex discipline, neurologic phenotype-specific serum and CSF antibody evaluations are recommended. Clinical trials have led to the approval of monoclonal therapies for neuromyelitis optica spectrum disorder (NMOSD) and are underway for N-methyl-d-aspartate (NMDA) receptor and leucine-rich glioma inactivated protein 1 (LGI1) encephalitides. ESSENTIAL POINTS Autoimmune neurology is now a mainstream subspecialty, consisting of disorders with diverse presentations detectable using antibody testing of serum and CSF. Early and sustained immunotherapy (eg, corticosteroids, intravenous immunoglobulin [IVIg], plasma exchange) is recommended and may be supplemented by immune suppressants (eg, rituximab or cyclophosphamide) to sustain responses and optimize outcomes.
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11
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Hacohen Y. Pediatric Autoimmune Neurologic Disorders. Continuum (Minneap Minn) 2024; 30:1160-1188. [PMID: 39088292 DOI: 10.1212/con.0000000000001464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2024]
Abstract
OBJECTIVE This article discusses common principles in diagnosing and managing autoimmune neurologic conditions in children. LATEST DEVELOPMENTS The key to improving outcomes in all patients with autoimmune neurologic diseases is making an early diagnosis, promptly initiating treatment, and identifying patients who will benefit from long-term maintenance treatment. Some neuroinflammatory syndromes can be diagnosed with an antibody biomarker (eg, aquaporin-4 antibodies, N-methyl-d-aspartate [NMDA] receptor antibodies), whereas others require clinical diagnostic criteria (eg, multiple sclerosis, opsoclonus-myoclonus syndrome). A proportion of children will be labeled as seronegative, and further investigations for other inflammatory or monogenetic etiologies need to be carried out in parallel with treating the central nervous system inflammation. Time to treatment and treatment escalation were shown to correlate with outcomes in many patients with these disorders. The choice and duration of treatment should be evaluated considering side effects and risks in the short and long terms. The presence of a highly inflammatory disease process in children supports the use of highly effective disease-modifying therapies in pediatrics. ESSENTIAL POINTS The phenotypes of pediatric autoimmune neurologic conditions may change across different age groups, as the brain is still actively developing. In general, the presentation in children is more inflammatory, but overall disability is lower, likely because of better neuroplasticity and repair. Convincing evidence has increasingly emerged to support the biological rationale that effective immunosuppressive therapies used in adult neuroimmunology are equally effective in children.
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12
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Jeyakumar N, Lerch M, Dale RC, Ramanathan S. MOG antibody-associated optic neuritis. Eye (Lond) 2024; 38:2289-2301. [PMID: 38783085 PMCID: PMC11306565 DOI: 10.1038/s41433-024-03108-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/04/2024] [Accepted: 04/19/2024] [Indexed: 05/25/2024] Open
Abstract
Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is a demyelinating disorder, distinct from multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). MOGAD most frequently presents with optic neuritis (MOG-ON), often with characteristic clinical and radiological features. Bilateral involvement, disc swelling clinically and radiologically, and longitudinally extensive optic nerve hyperintensity with associated optic perineuritis on MRI are key characteristics that can help distinguish MOG-ON from optic neuritis due to other aetiologies. The detection of serum MOG immunoglobulin G utilising a live cell-based assay in a patient with a compatible clinical phenotype is highly specific for the diagnosis of MOGAD. This review will highlight the key clinical and radiological features which expedite diagnosis, as well as ancillary investigations such as visual fields, visual evoked potentials and cerebrospinal fluid analysis, which may be less discriminatory. Optical coherence tomography can identify optic nerve swelling acutely, and atrophy chronically, and may transpire to have utility as a diagnostic and prognostic biomarker. MOG-ON appears to be largely responsive to corticosteroids, which are often the mainstay of acute management. However, relapses are common in patients in whom follow-up is prolonged, often in the context of early or rapid corticosteroid tapering. Establishing optimal acute therapy, the role of maintenance steroid-sparing immunotherapy for long-term relapse prevention, and identifying predictors of relapsing disease remain key research priorities in MOG-ON.
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Affiliation(s)
- Niroshan Jeyakumar
- Translational Neuroimmunology Group, Kids Neuroscience Centre and Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Department of Neurology, Westmead Hospital, Sydney, NSW, Australia
| | - Magdalena Lerch
- Translational Neuroimmunology Group, Kids Neuroscience Centre and Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Russell C Dale
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Clinical Neuroimmunology Group, Kids Neuroscience Centre and Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- TY Nelson Department of Neurology, Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Sudarshini Ramanathan
- Translational Neuroimmunology Group, Kids Neuroscience Centre and Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
- Department of Neurology, Concord Hospital, Sydney, NSW, Australia.
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Cortese R, Battaglini M, Prados F, Gentile G, Luchetti L, Bianchi A, Haider L, Jacob A, Palace J, Messina S, Paul F, Marignier R, Durand-Dubief F, de Medeiros Rimkus C, Apostolos Pereira SL, Sato DK, Filippi M, Rocca MA, Cacciaguerra L, Rovira À, Sastre-Garriga J, Arrambide G, Liu Y, Duan Y, Gasperini C, Tortorella C, Ruggieri S, Amato MP, Ulivelli M, Groppa S, Grothe M, Llufriu S, Sepulveda M, Lukas C, Bellenberg B, Schneider R, Sowa P, Celius EG, Pröbstel AK, Granziera C, Yaldizli Ö, Müller J, Stankoff B, Bodini B, Barkhof F, Ciccarelli O, De Stefano N. Grey Matter Atrophy and its Relationship with White Matter Lesions in Patients with Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease, Aquaporin-4 Antibody-Positive Neuromyelitis Optica Spectrum Disorder, and Multiple Sclerosis. Ann Neurol 2024; 96:276-288. [PMID: 38780377 DOI: 10.1002/ana.26951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 04/16/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE To evaluate: (1) the distribution of gray matter (GM) atrophy in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4+NMOSD), and relapsing-remitting multiple sclerosis (RRMS); and (2) the relationship between GM volumes and white matter lesions in various brain regions within each disease. METHODS A retrospective, multicenter analysis of magnetic resonance imaging data included patients with MOGAD/AQP4+NMOSD/RRMS in non-acute disease stage. Voxel-wise analyses and general linear models were used to evaluate the relevance of regional GM atrophy. For significant results (p < 0.05), volumes of atrophic areas are reported. RESULTS We studied 135 MOGAD patients, 135 AQP4+NMOSD, 175 RRMS, and 144 healthy controls (HC). Compared with HC, MOGAD showed lower GM volumes in the temporal lobes, deep GM, insula, and cingulate cortex (75.79 cm3); AQP4+NMOSD in the occipital cortex (32.83 cm3); and RRMS diffusely in the GM (260.61 cm3). MOGAD showed more pronounced temporal cortex atrophy than RRMS (6.71 cm3), whereas AQP4+NMOSD displayed greater occipital cortex atrophy than RRMS (19.82 cm3). RRMS demonstrated more pronounced deep GM atrophy in comparison with MOGAD (27.90 cm3) and AQP4+NMOSD (47.04 cm3). In MOGAD, higher periventricular and cortical/juxtacortical lesions were linked to reduced temporal cortex, deep GM, and insula volumes. In RRMS, the diffuse GM atrophy was associated with lesions in all locations. AQP4+NMOSD showed no lesion/GM volume correlation. INTERPRETATION GM atrophy is more widespread in RRMS compared with the other two conditions. MOGAD primarily affects the temporal cortex, whereas AQP4+NMOSD mainly involves the occipital cortex. In MOGAD and RRMS, lesion-related tract degeneration is associated with atrophy, but this link is absent in AQP4+NMOSD. ANN NEUROL 2024;96:276-288.
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Affiliation(s)
- Rosa Cortese
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
- Queen Square MS Center, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | - Marco Battaglini
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
- SIENA imaging SRL, Siena, Italy
| | - Ferran Prados
- Queen Square MS Center, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
- Center for Medical Imaging Computing, Medical Physics, and Biomedical Engineering, UCL, London, UK
- E-Health Center University Oberta de Catalunya, Barcelona, Spain
| | - Giordano Gentile
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
- SIENA imaging SRL, Siena, Italy
| | - Ludovico Luchetti
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
- SIENA imaging SRL, Siena, Italy
| | - Alessia Bianchi
- Queen Square MS Center, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | - Lukas Haider
- Queen Square MS Center, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | - Anu Jacob
- NMO Clinical Service at the Walton Centre, Liverpool, UK
- Department of Neurology, Cleveland Clinic, Abu Dhabi, UAE
| | - Jacqueline Palace
- Department of Clinical Neurology, John Radcliffe Hospital, Oxford, UK
| | - Silvia Messina
- Department of Clinical Neurology, John Radcliffe Hospital, Oxford, UK
| | - Friedemann Paul
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité-Universitaetsmedizin Berlin, Berlin, Germany
| | - Romain Marignier
- Department of Neurology, Multiple Sclerosis, Myelin Disorders, and Neuro-inflammation, Pierre Wertheimer Neurological Hospital, Hospices Civils de Lyon, Lyon, France
| | - Françoise Durand-Dubief
- Department of Neurology, Multiple Sclerosis, Myelin Disorders, and Neuro-inflammation, Pierre Wertheimer Neurological Hospital, Hospices Civils de Lyon, Lyon, France
| | - Carolina de Medeiros Rimkus
- Department of Radiology and Oncology, Faculty of Medicine, University of São Paulo (FMUSP), São Paulo, Brazil
| | | | - Douglas Kazutoshi Sato
- Pontifical Catholic University of Rio Grande do Sul (PUCRS), School of Medicine, Porto Alegre, Brazil
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Maria Assunta Rocca
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Laura Cacciaguerra
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Àlex Rovira
- Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jaume Sastre-Garriga
- Multiple Sclerosis Centre of Catalonia (Cemcat), Department of Neurology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Georgina Arrambide
- Multiple Sclerosis Centre of Catalonia (Cemcat), Department of Neurology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Yaou Liu
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yunyun Duan
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Claudio Gasperini
- Department of Neurosciences, S. Camillo-Forlanini Hospital, Rome, Italy
| | - Carla Tortorella
- Department of Neurosciences, S. Camillo-Forlanini Hospital, Rome, Italy
| | - Serena Ruggieri
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- Neuroimmunology Unit, IRCSS Fondazione Santa Lucia, Rome, Italy
| | - Maria Pia Amato
- Department Neurofarba, University of Florence, Florence, Italy
- IRCCS Don Carlo Gnocchi Foundation, Florence, Italy
| | - Monica Ulivelli
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Sergiu Groppa
- Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Matthias Grothe
- Department of Neurology, University Medicine of Greifswald, Greifswald, Germany
| | - Sara Llufriu
- Service of Neurology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Center of Neuroimmunology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), and Universitat de Barcelona, Barcelona, Spain
| | - Maria Sepulveda
- Service of Neurology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Center of Neuroimmunology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), and Universitat de Barcelona, Barcelona, Spain
| | - Carsten Lukas
- Institute of Neuroradiology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
- Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Barbara Bellenberg
- Institute of Neuroradiology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Ruth Schneider
- Institute of Neuroradiology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
- Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Piotr Sowa
- Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Elisabeth G Celius
- Department of Neurology, Oslo University Hospital and Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anne-Katrin Pröbstel
- Department of Neurology, Biomedicine and Clinical Research, and Research Center for Clinical Neuroimmunology and Neuroscience Basel, University Hospital and University of Basel, Basel, Switzerland
| | - Cristina Granziera
- Department of Neurology, Biomedicine and Clinical Research, and Research Center for Clinical Neuroimmunology and Neuroscience Basel, University Hospital and University of Basel, Basel, Switzerland
- Translational Imaging in Neurology (ThINk) Basel, Department of Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Özgür Yaldizli
- Department of Neurology, Biomedicine and Clinical Research, and Research Center for Clinical Neuroimmunology and Neuroscience Basel, University Hospital and University of Basel, Basel, Switzerland
| | - Jannis Müller
- Department of Neurology, Biomedicine and Clinical Research, and Research Center for Clinical Neuroimmunology and Neuroscience Basel, University Hospital and University of Basel, Basel, Switzerland
- Translational Imaging in Neurology (ThINk) Basel, Department of Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Bruno Stankoff
- Sorbonne University, Paris Brain Institute, ICM, Pitié Salpêtrière Hospital, Paris, France
| | - Benedetta Bodini
- Sorbonne University, Paris Brain Institute, ICM, Pitié Salpêtrière Hospital, Paris, France
| | - Frederik Barkhof
- Center for Medical Imaging Computing, Medical Physics, and Biomedical Engineering, UCL, London, UK
- Radiology & Nuclear medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Olga Ciccarelli
- Queen Square MS Center, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
- National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Center, London, UK
| | - Nicola De Stefano
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
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Cagol A, Tsagkas C, Granziera C. Advanced Brain Imaging in Central Nervous System Demyelinating Diseases. Neuroimaging Clin N Am 2024; 34:335-357. [PMID: 38942520 DOI: 10.1016/j.nic.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024]
Abstract
In recent decades, advances in neuroimaging have profoundly transformed our comprehension of central nervous system demyelinating diseases. Remarkable technological progress has enabled the integration of cutting-edge acquisition and postprocessing techniques, proving instrumental in characterizing subtle focal changes, diffuse microstructural alterations, and macroscopic pathologic processes. This review delves into state-of-the-art modalities applied to multiple sclerosis, neuromyelitis optica spectrum disorders, and myelin oligodendrocyte glycoprotein antibody-associated disease. Furthermore, it explores how this dynamic landscape holds significant promise for the development of effective and personalized clinical management strategies, encompassing support for differential diagnosis, prognosis, monitoring treatment response, and patient stratification.
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Affiliation(s)
- Alessandro Cagol
- Translational Imaging in Neurology (ThINk) Basel, Department of Biomedical Engineering, University Hospital Basel and University of Basel, Hegenheimermattweg 167b, 4123 Allschwil, Switzerland; Department of Neurology, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland; Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Spitalstrasse 2, 4031 Basel, Switzerland; Department of Health Sciences, University of Genova, Via A. Pastore, 1 16132 Genova, Italy. https://twitter.com/CagolAlessandr0
| | - Charidimos Tsagkas
- Translational Imaging in Neurology (ThINk) Basel, Department of Biomedical Engineering, University Hospital Basel and University of Basel, Hegenheimermattweg 167b, 4123 Allschwil, Switzerland; Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health (NIH), 10 Center Drive, Bethesda, MD 20892, USA
| | - Cristina Granziera
- Translational Imaging in Neurology (ThINk) Basel, Department of Biomedical Engineering, University Hospital Basel and University of Basel, Hegenheimermattweg 167b, 4123 Allschwil, Switzerland; Department of Neurology, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland; Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Spitalstrasse 2, 4031 Basel, Switzerland.
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15
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Sechi E. NMOSD and MOGAD. Continuum (Minneap Minn) 2024; 30:1052-1087. [PMID: 39088288 DOI: 10.1212/con.0000000000001454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2024]
Abstract
OBJECTIVE This article reviews the clinical features, MRI characteristics, diagnosis, and treatment of aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4-NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). The main differences between these disorders and multiple sclerosis (MS), the most common demyelinating disease of the central nervous system (CNS), are also highlighted. LATEST DEVELOPMENTS The past 20 years have seen important advances in understanding rare demyelinating CNS disorders associated with AQP4 IgG and myelin oligodendrocyte glycoprotein (MOG) IgG. The rapidly expanding repertoire of immunosuppressive agents approved for the treatment of AQP4-NMOSD and emerging as potentially beneficial in MOGAD mandates prompt recognition of these diseases. Most of the recent literature has focused on the identification of clinical and MRI features that help distinguish these diseases from each other and MS, simultaneously highlighting major diagnostic pitfalls that may lead to misdiagnosis. An awareness of the limitations of currently available assays for AQP4 IgG and MOG IgG detection is fundamental for identifying rare false antibody positivity and avoiding inappropriate treatments. For this purpose, diagnostic criteria have been created to help the clinician interpret antibody testing results and recognize the clinical and MRI phenotypes associated with AQP4-NMOSD and MOGAD. ESSENTIAL POINTS An awareness of the specific clinical and MRI features associated with AQP4-NMOSD and MOGAD and the limitations of currently available antibody testing assays is crucial for a correct diagnosis and differentiation from MS. The growing availability of effective treatment options will lead to personalized therapies and improved outcomes.
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Schindler P, Bellmann-Strobl J, Kuhle J, Wildemann B, Jarius S, Paul F, Ruprecht K. Longitudinal change of serum NfL as disease activity biomarker candidate in MOGAD: A descriptive cohort study. Mult Scler Relat Disord 2024; 88:105729. [PMID: 38901371 DOI: 10.1016/j.msard.2024.105729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND Myelin oligodendrocyte glycoprotein antibody (MOG-IgG)-associated disease (MOGAD) is an autoinflammatory disease of the central nervous system. MOGAD often follows a relapsing course that can lead to severe disability, but monophasic disease is possible as well. Currently, there is an unmet clinical need for disease activity biomarkers in MOGAD. Serum neurofilament light chain (sNfL) is a sensitive biomarker for neuroaxonal damage. However, data on longitudinal change of sNfL as disease activity biomarker for MOGAD are scarce. OBJECTIVE To describe the longitudinal course of sNfL in adult patients with MOGAD in an active as well as a stable disease state in relation to clinical parameters and serum MOG-IgG titers. METHODS We conducted a retrospective, exploratory, monocentric cohort study of adult patients with MOGAD. Cohort 1 consisted of five patients in whom NfL was tested as part of their routine clinical workup, all of which had active disease (maximum 6 months since last attack, median 3 months). Cohort 2 comprised 13 patients, which were tested for NfL in the context of a longitudinal study at predefined time intervals, mostly during remission (median 10 months since last attack). sNfL was measured using single molecule array (Simoa) technology at least at two time points (median 3) within a median observation time of 5 months in cohort 1, and at baseline and after a median duration of 12 months in cohort 2. MOG-IgG titers were measured by a fixed cell-based assay. RESULTS Change in sNfL correlated positively with change in MOG-IgG titers (rho=0.59, p = 0.027). The variability of sNfL (difference between highest and lowest level) during the observation period was higher in patients who had an attack within six months before baseline (median 37 [interquartile range [IQR] 10-64] pg/ml vs. 2.3 [IQR 1-5] pg/ml, p = 0.006). sNfL increased in patients with an attack during the observation period. Patients with baseline sNfL measurement within two weeks after attack symptom onset displayed relatively low initial sNfL with an increase afterwards. CONCLUSIONS Longitudinal sNfL change correlates with MOG-IgG titer change and may be a promising biomarker candidate for disease activity in MOGAD. Increasing sNfL levels might be utilized to adjudicate suspected attacks. In acute attacks, sNfL increase may occur with a delay after symptom onset.
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Affiliation(s)
- Patrick Schindler
- Department of Neurology, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Experimental and Clinical Research Center, a Cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany; Neuroscience Clinical Research Center, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
| | - Judith Bellmann-Strobl
- Experimental and Clinical Research Center, a Cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany; Neuroscience Clinical Research Center, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Jens Kuhle
- Multiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Departments of Biomedicine and Clinical Research, University Hospital and University of Basel, Basel, Switzerland; Department of Neurology, University Hospital and University of Basel, Basel, Switzerland
| | - Brigitte Wildemann
- Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Heidelberg, Germany
| | - Sven Jarius
- Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Heidelberg, Germany
| | - Friedemann Paul
- Department of Neurology, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Experimental and Clinical Research Center, a Cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany; Neuroscience Clinical Research Center, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Klemens Ruprecht
- Department of Neurology, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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17
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Jasperse B. Spinal Cord Imaging in Multiple Sclerosis and Related Disorders. Neuroimaging Clin N Am 2024; 34:385-398. [PMID: 38942523 DOI: 10.1016/j.nic.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024]
Abstract
Spinal cord MRI plays an important role in the diagnosis and prognosis of multiple sclerosis (MS) and related disorders. The ANATOMICAL, pathologic, imaging and prognostic consideriations for the spinal cord for MS and the most important other demyelinating disorders, neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein-associated disease, are reviewed. Finally, differential diagnostic considerations of spinal cord MRI in MS and related disorders are discussed.
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Affiliation(s)
- Bas Jasperse
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, de Boelelaan 1118, Amsterdam 1081HZ, the Netherlands.
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18
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Filippi M, Preziosa P, Margoni M, Rocca MA. Diagnostic Criteria for Multiple Sclerosis, Neuromyelitis Optica Spectrum Disorders, and Myelin Oligodendrocyte Glycoprotein-immunoglobulin G-associated Disease. Neuroimaging Clin N Am 2024; 34:293-316. [PMID: 38942518 DOI: 10.1016/j.nic.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024]
Abstract
The diagnostic workup of multiple sclerosis (MS) has evolved considerably. The 2017 revision of the McDonald criteria shows high sensitivity and accuracy in predicting clinically definite MS in patients with a typical clinically isolated syndrome and allows an earlier MS diagnosis. Neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein-immunoglobulin G-associated disease (MOGAD) are recognized as separate conditions from MS, with specific diagnostic criteria. New MR imaging markers may improve diagnostic specificity for these conditions, thus reducing the risk of misdiagnosis. This study summarizes the most recent updates regarding the application of MR imaging for the diagnosis of MS, NMOSD, and MOGAD.
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Affiliation(s)
- Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
| | - Paolo Preziosa
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Monica Margoni
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
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19
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Nasello M, Zancan V, Reniè R, Romano S, Buscarinu MC, Ristori G, Salvetti M, Bellucci G. Co-existence of Myelin Oligodendrocyte Glycoprotien Antibody-associated Disease (MOGAD) and Spinocerebellar Ataxia type 1 (SCA1): A case report. Neurol Sci 2024; 45:4067-4070. [PMID: 38512530 DOI: 10.1007/s10072-024-07479-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 03/17/2024] [Indexed: 03/23/2024]
Affiliation(s)
- Martina Nasello
- Department of Neurosciences, Mental Health and Sensory Organs, Centre for Experimental Neurological Therapies (CENTERS), Sapienza University of Rome, Rome, Italy
| | - Valeria Zancan
- Department of Neurosciences, Mental Health and Sensory Organs, Centre for Experimental Neurological Therapies (CENTERS), Sapienza University of Rome, Rome, Italy
| | - Roberta Reniè
- Department of Neurosciences, Mental Health and Sensory Organs, Centre for Experimental Neurological Therapies (CENTERS), Sapienza University of Rome, Rome, Italy
| | - Silvia Romano
- Department of Neurosciences, Mental Health and Sensory Organs, Centre for Experimental Neurological Therapies (CENTERS), Sapienza University of Rome, Rome, Italy
| | - Maria Chiara Buscarinu
- Department of Neurosciences, Mental Health and Sensory Organs, Centre for Experimental Neurological Therapies (CENTERS), Sapienza University of Rome, Rome, Italy
| | - Giovanni Ristori
- Department of Neurosciences, Mental Health and Sensory Organs, Centre for Experimental Neurological Therapies (CENTERS), Sapienza University of Rome, Rome, Italy
- Neuroimmunology Unit, Istituti Di Ricovero E Cura a Carattere Scientifico (IRCCS) Fondazione Santa Lucia, Rome, Italy
| | - Marco Salvetti
- Department of Neurosciences, Mental Health and Sensory Organs, Centre for Experimental Neurological Therapies (CENTERS), Sapienza University of Rome, Rome, Italy.
- Istituti Di Ricovero E Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy.
| | - Gianmarco Bellucci
- Department of Neurosciences, Mental Health and Sensory Organs, Centre for Experimental Neurological Therapies (CENTERS), Sapienza University of Rome, Rome, Italy
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20
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Frankl S, Viaene A, Vossough A, Waldman A, Hopkins S, Banwell B. Solitary Tumefactive Demyelinating Lesions in Children: Clinical and Magnetic Resonance Imaging Features, Pathologic Characteristics, and Outcomes. Pediatr Neurol 2024; 157:141-150. [PMID: 38917518 DOI: 10.1016/j.pediatrneurol.2024.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 05/03/2024] [Accepted: 05/14/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND Isolated tumefactive demyelinating lesions (≥2 cm) may be difficult to distinguish from contrast-enhancing brain tumors, central nervous system infections, and (rarely) tissue dysgenesis, which may all occur with increased signal on T2-weighted images. Establishing an accurate diagnosis is essential for management, and we delineate our single-center experience. METHODS We performed a retrospective review of medical records, imaging, and biopsy specimens for patients under 18 years presenting with isolated tumefactive demyelination over a 10-year period. RESULTS Ten children (eight female) met inclusion criteria, with a median age of 14.1 years. Lesions were most likely to involve the thalamus (six of 10), brainstem (five of 10), basal ganglia (four of 10), or corpus callosum (four of 10). Eighty percent had perilesional edema at presentation, and 60% had midline shift. Biopsies demonstrated demyelination with perivascular lymphocytic infiltration and axonal damage ranging from mild to severe. All patients were initially treated with high-dose corticosteroids, and eight of 10 required additional medical therapies such as intravenous immunoglobulin, plasmapheresis, cyclophosphamide, or rituximab. Increased intracranial pressure was managed aggressively with two of 10 patients requiring decompressive craniectomies. Clinical outcomes varied. CONCLUSIONS Solitary tumefactive demyelinating lesions are rare, and aggressive management of inflammation and increased intracranial pressure is essential. Biopsy is helpful to evaluate for other diagnoses on the differential and maximize therapies. Treatment beyond initial therapy with corticosteroids is often required. Isolated tumefactive demyelinating lesions are uncommon; multicenter natural history studies are needed to better delineate differential diagnoses and optimal therapies.
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Affiliation(s)
- Sarah Frankl
- Department of Neurology, C.S. Mott Children's Hospital, Ann Arbor, Michigan
| | - Angela Viaene
- Division of Anatomic Pathology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Arastoo Vossough
- Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Amy Waldman
- Department of Neurology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Sarah Hopkins
- Department of Neurology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
| | - Brenda Banwell
- Department of Neurology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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21
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Rovira À, Vidal-Jordana A, Auger C, Sastre-Garriga J. Optic Nerve Imaging in Multiple Sclerosis and Related Disorders. Neuroimaging Clin N Am 2024; 34:399-420. [PMID: 38942524 DOI: 10.1016/j.nic.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024]
Abstract
Optic neuritis is a common feature in multiple sclerosis and in 2 other autoimmune demyelinating disorders such as aquaporin-4 IgG antibody-associated neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein antibody-associated disease. Although serologic testing is critical for differentiating these different autoimmune-mediated disorders, MR imaging, which is the preferred imaging modality for assessing the optic nerve, can provide valuable information, suggesting a specific diagnosis and guiding the appropriate serologic testing.
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Affiliation(s)
- Àlex Rovira
- Department of Radiology, Section of Neuroradiology, Vall d'Hebron University Hospital, Autonomous Univesity of Barcelona, Barcelona, Spain.
| | - Angela Vidal-Jordana
- Department of Neurology, Centro de Esclerosis Múltiple de Catalunya (Cemcat), Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain
| | - Cristina Auger
- Department of Radiology, Section of Neuroradiology, Vall d'Hebron University Hospital, Autonomous Univesity of Barcelona, Barcelona, Spain
| | - Jaume Sastre-Garriga
- Department of Neurology, Centro de Esclerosis Múltiple de Catalunya (Cemcat), Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain
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22
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Ciarletta J, Weinstock-Guttman B, Thapa S, Mirmosayyeb O, Awan S, Eckert S. Bickerstaff brain stem encephalitis preceding recurrent myelin oligodendrocyte glycoprotein antibody-associated disease. Acta Neurol Belg 2024; 124:1447-1449. [PMID: 38498264 DOI: 10.1007/s13760-024-02528-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 03/13/2024] [Indexed: 03/20/2024]
Affiliation(s)
- John Ciarletta
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, 955 Main St, Buffalo, NY, 14203, USA.
| | - Bianca Weinstock-Guttman
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, 955 Main St, Buffalo, NY, 14203, USA
- Jacobs Multiple Sclerosis Center for Treatment and Research, Buffalo, USA
| | - Sangharsha Thapa
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, 955 Main St, Buffalo, NY, 14203, USA
- Jacobs Multiple Sclerosis Center for Treatment and Research, Buffalo, USA
| | - Omid Mirmosayyeb
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, 955 Main St, Buffalo, NY, 14203, USA
- Jacobs Multiple Sclerosis Center for Treatment and Research, Buffalo, USA
| | - Samreen Awan
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, 955 Main St, Buffalo, NY, 14203, USA
- Jacobs Multiple Sclerosis Center for Treatment and Research, Buffalo, USA
| | - Svetlana Eckert
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, 955 Main St, Buffalo, NY, 14203, USA
- Jacobs Multiple Sclerosis Center for Treatment and Research, Buffalo, USA
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23
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Kim S, Eun MY, Lee JJ, Seok HY. Trigeminal involvement in MOG antibody-associated brainstem encephalitis: a distinct clinico-radiographic presentation. Acta Neurol Belg 2024; 124:1433-1438. [PMID: 38401038 DOI: 10.1007/s13760-024-02496-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/08/2024] [Indexed: 02/26/2024]
Affiliation(s)
- Sohyeon Kim
- Department of Neurology, Dongsan Hospital, Keimyung University School of Medicine, 1035 Dalgubeol-daero, Dalseo-gu, Daegu, 42601, Republic of Korea
| | - Mi-Yeon Eun
- Department of Neurology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Jae-Joon Lee
- Department of Neurology, Dongsan Hospital, Keimyung University School of Medicine, 1035 Dalgubeol-daero, Dalseo-gu, Daegu, 42601, Republic of Korea
| | - Hung Youl Seok
- Department of Neurology, Dongsan Hospital, Keimyung University School of Medicine, 1035 Dalgubeol-daero, Dalseo-gu, Daegu, 42601, Republic of Korea.
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24
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Papetti L, Moltoni G, Longo D, Monte G, Dellepiane F, Pro S, Bracaglia G, Ruscitto C, Verrotti A, Valeriani M. Isolated Intracranial Hypertensions as Onset of Myelin Oligodendrocyte Glycoprotein Antibody Disease. J Clin Med 2024; 13:4468. [PMID: 39124735 DOI: 10.3390/jcm13154468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 07/25/2024] [Accepted: 07/29/2024] [Indexed: 08/12/2024] Open
Abstract
Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) is characterized by multiple phenotypic conditions such as acute disseminated encephalomyelitis, optic neuritis, and myelitis. MOGAD's spectrum is expanding, with potential symptoms of increased intracranial pressure that are similar to idiopathic intracranial hypertension (IIH). We report a boy with new-onset continuous headache and a brain MRI at onset suggesting idiopathic intracranial hypertension (IIH). The patient showed resistance to treatment with acetazolamide and, after one month, developed optic neuritis in the left eye. Laboratory tests documented positive MOG antibodies (anti-MOG) in the serum. The final diagnosis was MOGAD, with the initial symptoms resembling IIH.
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Affiliation(s)
- Laura Papetti
- Developmental Neurology Unit, Bambino Gesù Children's Hospital IRCCS, 00165 Rome, Italy
| | - Giulia Moltoni
- Functional and Interventional Neuroradiology Unit, Bambino Gesù Children's Hospital IRCCS, 00165 Rome, Italy
- Neuroradiology Unit, NESMOS Department Sant'Andrea Hospital, La Sapienza University, Via di Grottarossa, 1035-1039, 00189 Rome, Italy
| | - Daniela Longo
- Functional and Interventional Neuroradiology Unit, Bambino Gesù Children's Hospital IRCCS, 00165 Rome, Italy
| | - Gabriele Monte
- Developmental Neurology Unit, Bambino Gesù Children's Hospital IRCCS, 00165 Rome, Italy
| | - Francesco Dellepiane
- Functional and Interventional Neuroradiology Unit, Bambino Gesù Children's Hospital IRCCS, 00165 Rome, Italy
| | - Stefano Pro
- Developmental Neurology Unit, Bambino Gesù Children's Hospital IRCCS, 00165 Rome, Italy
| | - Giorgia Bracaglia
- Department of Diagnostics and Laboratory Medicine, Medical Laboratory Unit, Unit of Allergy and Autoimmunity, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Claudia Ruscitto
- Developmental Neurology Unit, Bambino Gesù Children's Hospital IRCCS, 00165 Rome, Italy
| | - Alberto Verrotti
- Department of Pediatrics, University of Perugia, 06123 Perugia, Italy
| | - Massimiliano Valeriani
- Developmental Neurology Unit, Bambino Gesù Children's Hospital IRCCS, 00165 Rome, Italy
- Systems Medicine Department, Hospital of Rome, Tor Vergata University, 00133 Rome, Italy
- Center for Sensory Motor Interaction, Aalborg University, DK-9220 Aalborg, Denmark
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25
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Passoke S, Stern C, Häußler V, Kümpfel T, Havla J, Engels D, Jarius S, Wildemann B, Korporal-Kuhnke M, Senel M, Stellmann JP, Warnke C, Grothe M, Schülke R, Gingele S, Kretschmer JR, Klotz L, Walter A, Then Bergh F, Aktas O, Ringelstein M, Ayzenberg I, Schwake C, Kleiter I, Sperber PS, Rust R, Schindler P, Bellmann-Strobl J, Paul F, Kopp B, Trebst C, Hümmert MW. Cognition in patients with myelin oligodendrocyte glycoprotein antibody-associated disease: a prospective, longitudinal, multicentre study of 113 patients (CogniMOG-Study). J Neurol Neurosurg Psychiatry 2024:jnnp-2024-333994. [PMID: 39084862 DOI: 10.1136/jnnp-2024-333994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 07/08/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Data on cognition in patients with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are limited to studies with small sample sizes. Therefore, we aimed to analyse the extent, characteristics and the longitudinal course of potential cognitive deficits in patients with MOGAD. METHODS The CogniMOG-Study is a prospective, longitudinal and multicentre observational study of 113 patients with MOGAD. Individual cognitive performance was assessed using the Paced Auditory Serial Addition Task (PASAT), the Symbol Digit Modalities Test (SDMT) and the Multiple Sclerosis Inventory Cognition (MuSIC), which are standardised against normative data from healthy controls. Cognitive performance was assessed at baseline and at 1-year and 2-year follow-up assessments. Multiple linear regression was used to analyse demographic and clinical predictors of cognitive deficits identified in previous correlation analyses. RESULTS At baseline, the study sample of MOGAD patients showed impaired standardised performance on MuSIC semantic fluency (mean=-0.29, 95% CI (-0.47 to -0.12)) and MuSIC congruent speed (mean=-0.73, 95% CI (-1.23 to -0.23)). Around 1 in 10 patients showed deficits in two or more cognitive measures (11%). No decline in cognition was observed during the 1-year and 2-year follow-up period. Cerebral lesions were found to be negatively predictive for SDMT (B=-8.85, 95% CI (-13.57 to -4.14)) and MuSIC semantic fluency (B=-4.17, 95% CI (-6.10 to -2.25)) test performance. CONCLUSIONS Based on these data, we conclude that MOGAD patients show reduced visuomotor processing speed and semantic fluency to the extent that the disease burden includes cerebral lesions.
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Affiliation(s)
- Sarah Passoke
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Carlotta Stern
- Department of Neurology, Hannover Medical School, Hannover, Germany
- University Hospital Innsbruck, Innsbruck, Austria
| | - Vivien Häußler
- Department of Neurology and Institute of Neuroimmunology and MS (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tania Kümpfel
- Institute of Clinical Neuroimmunology, University Hospital Munich, Ludwig Maximilian University Munich, Munich, Germany
| | - Joachim Havla
- Institute of Clinical Neuroimmunology, University Hospital Munich, Ludwig Maximilian University Munich, Munich, Germany
| | - Daniel Engels
- Institute of Clinical Neuroimmunology, University Hospital Munich, Ludwig Maximilian University Munich, Munich, Germany
| | - Sven Jarius
- Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Heidelberg, Germany
| | - Brigitte Wildemann
- Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Heidelberg, Germany
| | - Mirjam Korporal-Kuhnke
- Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Heidelberg, Germany
| | - Makbule Senel
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Jan-Patrick Stellmann
- Department of Neurology and Institute of Neuroimmunology and MS (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Aix-Marseille Univ, CNRS, CRMBM, UMR 7339, Marseille Cedex, France
- APHM, Hopital de la Timone, CEMEREM, Marseille, France
| | - Clemens Warnke
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Matthias Grothe
- Department of Neurology, University Medicine of Greifswald, Greifswald, Germany
| | - Rasmus Schülke
- Department of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Stefan Gingele
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | | | - Luisa Klotz
- Department of Neurology, University of Münster, Münster, Germany
| | - Annette Walter
- Department of Neurology, Herford Hospital, Herford, Germany
| | | | - Orhan Aktas
- Department of Neurology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Marius Ringelstein
- Department of Neurology, Medical Faculty and University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Neurology, Center for Neurology and Neuropsychiatry, LVR-Klinikum, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Ilya Ayzenberg
- Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Carolin Schwake
- Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Ingo Kleiter
- Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
- Marianne-Strauß-Klinik, Behandlungszentrum Kempfenhausen für Multiple Sklerose Kranke, Berg, Germany
| | - Pia Sophie Sperber
- Germany Center for Cardiovascular Diseases (DZHK), partner site Berlin, Berlin, Germany
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Neuroscience Clinical Research Center (NCRC), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Experimental and Clinical Research Center, a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin, Berlin, Germany
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Rebekka Rust
- Neuroscience Clinical Research Center (NCRC), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Experimental and Clinical Research Center, a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin, Berlin, Germany
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Patrick Schindler
- Neuroscience Clinical Research Center (NCRC), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Experimental and Clinical Research Center, a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin, Berlin, Germany
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Judith Bellmann-Strobl
- Neuroscience Clinical Research Center (NCRC), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Experimental and Clinical Research Center, a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Friedemann Paul
- Neuroscience Clinical Research Center (NCRC), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Experimental and Clinical Research Center, a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin, Berlin, Germany
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Bruno Kopp
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Corinna Trebst
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Martin W Hümmert
- Department of Neurology, Hannover Medical School, Hannover, Germany
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Manzano GS, Levy M, Salky R, Mateen FJ, Klawiter EC, Chitnis T, Vasileiou ES, Sotirchos ES, Gibbons E, Huda S, Jacob A, Matiello M. Assessment of international MOGAD diagnostic criteria in patients with overlapping MOG-associated disease and multiple sclerosis phenotypes. J Neurol 2024:10.1007/s00415-024-12585-w. [PMID: 39066792 DOI: 10.1007/s00415-024-12585-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 07/11/2024] [Accepted: 07/13/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND The clinical spectrum and diagnosis of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) has evolved in the setting of an optimized anti-MOG-IgG cell-based assay and expert consensus. The McDonald criteria for MS have been revised multiple times to improve the accuracy and specificity of diagnosis on a framework based on clinical presentation, MRI findings, and CSF results. While the uses of MS and MOGAD diagnostic criteria are helpful for typical cases, such utility for patients with overlapping clinical, laboratorial, and imaging features is unknown, posing diagnostic and management uncertainties. OBJECTIVES To report a multicenter cohort of patients with overlapping phenotypic features of MOGAD and MS and evaluate the application of new MOGAD diagnostic criteria. METHODS A collaborative retrospective cohort study was performed to identify patients with both positive serum anti-MOG-IgG and fulfillment of the MS revised 2017 McDonald criteria. Clinical and radiographic features of patients fulfilling inclusion criteria were reviewed longitudinally, including relapses, repeated MRI, and MOG-IgG testing in detail to allow the panel of expert opinion to assign to each case. The International MOGAD Panel proposed criteria were applied at onset and last follow-up to each case and compared to the expert author diagnosis assignment based on presentation, clinical and imaging features, and response to treatment. RESULTS Ten of 225 (4%) MOG-IgG seropositive cases met study inclusion criteria [seven of 10 were female; age at initial event: eight adults (mean age 26.8 years), two adolescents (mean age 14.5 years)]. AQP4-IgG was negative for all. Apart from serum titers of MOG-IgG, distinguishing clinical and radiographic features [i.e., clinical severity of the initial demyelinating event, radiographic features (optic nerve/spine/brain), and presence/absence of lesion normalization on serial scans] led to consensus of three separate classifications differing by degrees of shared features of MOGAD and MS. Patients were classified by expert panel into (1) Classic MOGAD even with MS-like, well-defined brain lesions, when severe events and most T2 lesions normalized (n = 5; MOG-IgG titers 1:100, 1:20, 1:160, 1:40, 1:200); (2) Classic RRMS included cases thought to have likely false positive or clinically irrelevant MOG-IgG, due to mild clinical events and no radiographic normalization of well-defined MS-like lesions (n = 3; MOG titers 1:20, 1:100, 1:40); (3) MOGAD and MS overlapping phenotype was defined by those with a combination of mild and severe clinical events, partial T2 lesion normalization, both well- and ill-defined lesions (n = 2; MOG titers 1:20, 1:100). The application of the International MOGAD Panel criteria categorized five patients (50%) in agreement with expert assignment. One additional patient was classified in agreement to assignment when MOGAD criteria were applied after serial MOG-IgG titers testing. DISCUSSION While the International MOGAD Panel diagnostic criteria have helped with accuracy for the diagnosis of this condition, in a group of patients seropositive for MOG-IgG with overlapping clinical and imaging features of RRMS criteria review may lead to increased accuracy. Serial serologies, repeated imaging, close attention to clinical course, and response to therapy are possible variables to consider for further refinement of MOGAD diagnostic criteria.
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Affiliation(s)
- Giovanna S Manzano
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, 15 Parkman Street, Wang 8-835, Boston, MA, 02114, USA
- Department of Neurology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Michael Levy
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, 15 Parkman Street, Wang 8-835, Boston, MA, 02114, USA
| | - Rebecca Salky
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, 15 Parkman Street, Wang 8-835, Boston, MA, 02114, USA
| | - Farrah J Mateen
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, 15 Parkman Street, Wang 8-835, Boston, MA, 02114, USA
| | - Eric C Klawiter
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, 15 Parkman Street, Wang 8-835, Boston, MA, 02114, USA
| | - Tanuja Chitnis
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, 15 Parkman Street, Wang 8-835, Boston, MA, 02114, USA
- Department of Neurology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Eleni S Vasileiou
- Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Elias S Sotirchos
- Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | | - Saif Huda
- Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Anu Jacob
- Section of Multiple Sclerosis and Autoimmune Neurology, Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | - Marcelo Matiello
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, 15 Parkman Street, Wang 8-835, Boston, MA, 02114, USA.
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Schneider R, Kogel AK, Ladopoulos T, Siems N, Krieger B, Bellenberg B, Gold R, Ayzenberg I, Lukas C. Cortical atrophy patterns in myelin oligodendrocyte glycoprotein antibody-associated disease. Ann Clin Transl Neurol 2024. [PMID: 39054631 DOI: 10.1002/acn3.52137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 06/07/2024] [Accepted: 06/09/2024] [Indexed: 07/27/2024] Open
Abstract
OBJECTIVES Global brain volume changes in patients with myelin oligodendrocyte glycoprotein antibody-associated disease compared with healthy controls (HC) could be revealed by magnetic resonance imaging, but specific atrophy patterns of cortical structures and relation to cognitive impairment are not yet comprehensively known. Thus, we aimed to investigate cortical thickness differences in patients with myelin oligodendrocyte glycoprotein antibody-associated disease compared with HC. METHODS 3-Tesla brain magnetic resonance imaging was performed in 23 patients with myelin oligodendrocyte glycoprotein antibody-associated disease and 49 HC for voxel-wise group comparisons and neuropsychological testing in patients. Surface-based morphometry with region of interest-based surface analysis and region of interest-based extraction of cortical thickness was performed in patients compared with HC and in patient subgroups with and without cognitive impairment. RESULTS Comparing patients with myelin oligodendrocyte glycoprotein antibody-associated disease with HC, exploratory surface-based morphometry demonstrated cortical volume reduction in pericalcarine and lingual cortical regions. Region of interest-based surface analysis specified reduced cortical thickness in the adjacent pericalcarine and orbitofrontal regions in myelin oligodendrocyte glycoprotein antibody-associated disease, as well as reduced temporal cortical thickness in patients with cognitive impairment (n = 10). Patients without cognitive impairment (n = 13) showed only circumscribed cortical brain volume loss compared with HC in the pericalcarine region. INTERPRETATION In conclusion, cortical atrophy in myelin oligodendrocyte glycoprotein antibody-associated disease was characterized by cortical thickness reduction in the adjacent pericalcarine and orbitofrontal regions, with a tendency of temporal thickness reduction in cognitively impaired patients.
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Affiliation(s)
- Ruth Schneider
- Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
- Institute of Neuroradiology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Ann-Kathrin Kogel
- Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Theodoros Ladopoulos
- Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
- Institute of Neuroradiology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Nadine Siems
- Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Britta Krieger
- Institute of Neuroradiology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Barbara Bellenberg
- Institute of Neuroradiology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Ralf Gold
- Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Ilya Ayzenberg
- Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Carsten Lukas
- Institute of Neuroradiology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
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Mirza AI, Zhu F, Knox N, Black LJ, Daly A, Bonner C, Van Domselaar G, Bernstein CN, Marrie RA, Hart J, Yeh EA, Bar-Or A, O'Mahony J, Zhao Y, Hsiao W, Banwell B, Waubant E, Tremlett H. Mediterranean diet and associations with the gut microbiota and pediatric-onset multiple sclerosis using trivariate analysis. COMMUNICATIONS MEDICINE 2024; 4:148. [PMID: 39030379 PMCID: PMC11271616 DOI: 10.1038/s43856-024-00565-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 07/02/2024] [Indexed: 07/21/2024] Open
Abstract
BACKGROUND The interplay between diet and the gut microbiota in multiple sclerosis (MS) is poorly understood. We aimed to assess the interrelationship between diet, the gut microbiota, and MS. METHODS We conducted a case-control study including 95 participants (44 pediatric-onset MS cases, 51 unaffected controls) enrolled from the Canadian Pediatric Demyelinating Disease Network study. All had completed a food frequency questionnaire ≤21-years of age, and 59 also provided a stool sample. RESULTS Here we show that a 1-point increase in a Mediterranean diet score is associated with 37% reduced MS odds (95%CI: 10%-53%). Higher fiber and iron intakes are also associated with reduced MS odds. Diet, not MS, explains inter-individual gut microbiota variation. Several gut microbes abundances are associated with both the Mediterranean diet score and having MS, and these microbes are potential mediators of the protective associations of a healthier diet. CONCLUSIONS Our findings suggest that the potential interaction between diet and the gut microbiota is relevant in MS.
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Affiliation(s)
- Ali I Mirza
- Department of Medicine (Neurology), The University of British Columbia, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Feng Zhu
- Department of Medicine (Neurology), The University of British Columbia, Vancouver, BC, Canada
| | - Natalie Knox
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - Lucinda J Black
- Curtin School of Population Health, Curtin University, Perth, WA, Australia
- Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Alison Daly
- Curtin School of Population Health, Curtin University, Perth, WA, Australia
| | - Christine Bonner
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Gary Van Domselaar
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - Charles N Bernstein
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Inflammatory Bowel Disease Clinical and Research Centre, University of Manitoba, Winnipeg, MB, Canada
| | - Ruth Ann Marrie
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Janace Hart
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - E Ann Yeh
- Department of Pediatrics (Neurology), The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Amit Bar-Or
- Centre for Neuroinflammation and Experimental Therapeutics and Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Julia O'Mahony
- Department of Pediatrics (Neurology), The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Yinshan Zhao
- Department of Medicine (Neurology), The University of British Columbia, Vancouver, BC, Canada
| | - William Hsiao
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Brenda Banwell
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Division of Child Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Emmanuelle Waubant
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Helen Tremlett
- Department of Medicine (Neurology), The University of British Columbia, Vancouver, BC, Canada.
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Yamada N, Inoue T, Kuki I, Yamamoto N, Fukuoka M, Nukui M, Okuno H, Ishikawa J, Amo K, Togawa M, Sakuma H, Okazaki S. Higher incidence of acute symptomatic seizures in probable antibody-negative pediatric autoimmune encephalitis than in major antibody-positive autoimmune encephalitis. Front Neurol 2024; 15:1418083. [PMID: 39099783 PMCID: PMC11294254 DOI: 10.3389/fneur.2024.1418083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 07/03/2024] [Indexed: 08/06/2024] Open
Abstract
Purpose To delineate the characteristics of probable antibody-negative pediatric autoimmune encephalitis (probable Ab-negative AE), we compared the clinical features of probable Ab-negative AE to those of major antibody-positive AE. Methods We retrospectively reviewed the clinical features of 18 patients with probable Ab-negative AE, 13 with anti-N-methyl-D-aspartate receptor encephalitis (NMDARE), and 13 with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). Clinical characteristics, neuroimaging findings, treatments, and outcomes were analyzed. Results The age of onset and length of hospital stay were significantly higher in the NMDARE group than in the other groups (p = 0.02 and p < 0.01). Regarding initial neurological symptoms, acute symptomatic seizures in the probable Ab-negative AE group (67%) were significantly more frequent than in the NMDARE (15%) and MOGAD (23%) groups (p < 0.01). Paraclinical evidence of neuroinflammation within 1 month of disease onset revealed that single-photon emission computed tomography (SPECT) detected abnormal alterations in 14/14 (100%), cerebrospinal fluid (CSF) analysis in 15/18 (83%), and magnetic resonance imaging (MRI) in 11/18 (61%) in patients with probable Ab-negative AE. In the probable Ab-negative AE group, seven patients (39%) developed autoimmune-associated epilepsy, whereas one patient (8%) had both NMDARE and MOGAD (not statistically significant, p = 0.07). Conclusion Patients with probable Ab-negative AE exhibited acute symptomatic seizures as initial neurological symptoms significantly more frequently. They developed autoimmune-associated epilepsy more frequently than those with NMDARE and MOGAD, which was not statistically significant. SPECT within 1 month of disease onset might be a valuable surrogate marker of ongoing neuroinflammation and neuronal dysfunction, even in patients with negative MRI findings.
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Affiliation(s)
- Naoki Yamada
- Department of Pediatric Neurology and Logopedics, Osaka City General Hospital, Osaka, Japan
| | - Takeshi Inoue
- Department of Pediatric Neurology and Logopedics, Osaka City General Hospital, Osaka, Japan
| | - Ichiro Kuki
- Department of Pediatric Neurology and Logopedics, Osaka City General Hospital, Osaka, Japan
| | - Naohiro Yamamoto
- Department of Pediatric Neurology and Logopedics, Osaka City General Hospital, Osaka, Japan
| | - Masataka Fukuoka
- Department of Pediatric Neurology and Logopedics, Osaka City General Hospital, Osaka, Japan
| | - Megumi Nukui
- Department of Pediatric Neurology and Logopedics, Osaka City General Hospital, Osaka, Japan
| | - Hideo Okuno
- Department of Pediatric Emergency, Infectious Disease Internal Medicine, Osaka City General Hospital, Osaka, Japan
| | - Junichi Ishikawa
- Department of Pediatric Emergency, Infectious Disease Internal Medicine, Osaka City General Hospital, Osaka, Japan
| | - Kiyoko Amo
- Department of Pediatric Emergency, Infectious Disease Internal Medicine, Osaka City General Hospital, Osaka, Japan
| | - Masao Togawa
- Department of Pediatric Emergency, Infectious Disease Internal Medicine, Osaka City General Hospital, Osaka, Japan
| | - Hiroshi Sakuma
- Department of Brain and Neuroscience, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Shin Okazaki
- Department of Pediatric Neurology and Logopedics, Osaka City General Hospital, Osaka, Japan
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Carnero Contentti E, Lopez PA, Pettinicchi JP, Miguez J, Patrucco L, Cristiano E, Liwacki S, Tkachuk V, Balbuena ME, Vrech C, Deri N, Correale J, Marrodan M, Ysrraelit MC, Leguizamon F, Luetic G, Tavolini D, Mainella C, Zanga G, Burgos M, Hryb J, Barboza A, Lazaro L, Alonso R, Fernández Liguori N, Nadur D, Alonso Serena M, Caride A, Rojas JI. Treatment strategies and responses for attacks of neuromyelitis optica spectrum disorder: A real-world retrospective cohort study. J Neurol Sci 2024; 462:123099. [PMID: 38897155 DOI: 10.1016/j.jns.2024.123099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 06/11/2024] [Accepted: 06/13/2024] [Indexed: 06/21/2024]
Abstract
We aimed to assess the treatment strategies utilized in patients with neuromyelitis optica spectrum disorder (NMOSD) experiencing relapses, including their frequency, types, and response after 6 months based on the Expanded Disability Status Scale (EDSS) score. METHODS We conducted a retrospective study involving NMOSD patients from the Argentinean MS and NMOSD registry (RelevarEM, NCT03375177). Treatment response at 6 months was categorized as "good" if the EDSS score decreased by ≥1 point after a nadir EDSS score ≤ 3, or by ≥2 points after a nadir EDSS score > 3, "poor" if the EDSS score decrease was slighter, and as "absent" if the EDSS score remained unchanged or worsened. RESULTS We included 120 NMOSD patients (seropositive N = 75), who experienced 250 NMOSD-related relapses and received 248 treatments. At 6 months, complete recovery was achieved in 70/98 (71.4%) and 15/19 (79%) patients, respectively. Predictors of a "good" response in our regression model were a younger age at disease onset (OR:3.54, CI95% 2.45-5.01, p < 0.0001) and a short delay from onset of relapse to treatment initiation (OR:1.56, CI95% 1.22-2.13, p = 0.004). CONCLUSIONS Approximately two-thirds of patients experienced complete recovery, and younger age and a short delay to start treatment were independent predictors of a "good" response.
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Affiliation(s)
- Edgar Carnero Contentti
- Neuroimmunology Unit, Department of Neurosciences, Hospital Alemán, Buenos Aires, Argentina.
| | - Pablo A Lopez
- Neuroimmunology Unit, Department of Neurosciences, Hospital Alemán, Buenos Aires, Argentina
| | - Juan Pablo Pettinicchi
- Neuroimmunology Unit, Department of Neurosciences, Hospital Alemán, Buenos Aires, Argentina
| | - Jimena Miguez
- Servicio de Neurología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Liliana Patrucco
- Centro de esclerosis múltiple de Buenos Aires, Buenos Aires, Argentina
| | - Edgardo Cristiano
- Centro de esclerosis múltiple de Buenos Aires, Buenos Aires, Argentina
| | - Susana Liwacki
- Clínica Universitaria Reina Fabiola, Córdoba, Argentina; Servicio de Neurología - Hospital Córdoba, Córdoba
| | - Verónica Tkachuk
- Sección de Neuroinmunología y Enfermedades Desmielinizantes, Servicio de Neurología - Hospital de Clínicas José de San Martín, Buenos Aires, Argentina
| | - María E Balbuena
- Sección de Neuroinmunología y Enfermedades Desmielinizantes, Servicio de Neurología - Hospital de Clínicas José de San Martín, Buenos Aires, Argentina
| | - Carlos Vrech
- Departamento de Enfermedades desmielinizantes - Sanatorio Allende, Córdoba, Argentina
| | | | - Jorge Correale
- Departamento de Neurología - FLENI, Buenos Aires, Argentina
| | | | | | | | | | | | | | - Gisela Zanga
- Unidad asistencial César Milstein, Buenos Aires, Argentina
| | - Marcos Burgos
- Servicio de Neurología - Hospital San Bernardo, Salta, Argentina
| | - Javier Hryb
- Servicio de Neurología - Hospital Carlos G. Durand, Buenos Aires, Argentina
| | | | | | | | | | - Débora Nadur
- Sección de Neuroinmunología y Enfermedades Desmielinizantes, Servicio de Neurología - Hospital de Clínicas José de San Martín, Buenos Aires, Argentina; Hospital Naval, Buenos Aires, Argentina
| | - Marina Alonso Serena
- Servicio de clínica médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Alejandro Caride
- Neuroimmunology Unit, Department of Neurosciences, Hospital Alemán, Buenos Aires, Argentina
| | - Juan I Rojas
- Centro de esclerosis múltiple de Buenos Aires, Buenos Aires, Argentina; Servicio de Neurología, Hospital Universitario de CEMIC, Buenos Aires, Argentina
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Min YG, Moon Y, Kwon YN, Lee BJ, Park KA, Han JY, Han J, Lee HJ, Baek SH, Kim BJ, Kim JS, Park KS, Kim NH, Kim M, Nam TS, Oh SI, Jung JH, Sung JJ, Jang MJ, Kim SJ, Kim SM. Prognostic factors of first-onset optic neuritis based on diagnostic criteria and antibody status: a multicentre analysis of 427 eyes. J Neurol Neurosurg Psychiatry 2024; 95:753-760. [PMID: 38418215 DOI: 10.1136/jnnp-2023-333133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/22/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Optic neuritis (ON) prognosis is influenced by various factors including attack severity, underlying aetiologies, treatments and consequences of previous episodes. This study, conducted on a large cohort of first ON episodes, aimed to identify unique prognostic factors for each ON subtype, while excluding any potential influence from pre-existing sequelae. METHODS Patients experiencing their first ON episodes, with complete aquaporin-4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG) antibody testing, and clinical data for applying multiple sclerosis (MS) diagnostic criteria, were enrolled. 427 eyes from 355 patients from 10 hospitals were categorised into four subgroups: neuromyelitis optica with AQP4 IgG (NMOSD-ON), MOG antibody-associated disease (MOGAD-ON), ON in MS (MS-ON) or idiopathic ON (ION). Prognostic factors linked to complete recovery (regaining 20/20 visual acuity (VA)) or moderate recovery (regaining 20/40 VA) were assessed through multivariable Cox regression analysis. RESULTS VA at nadir emerged as a robust prognostic factor for both complete and moderate recovery, spanning all ON subtypes. Early intravenous methylprednisolone (IVMP) was associated with enhanced complete recovery in NMOSD-ON and MOGAD-ON, but not in MS-ON or ION. Interestingly, in NMOSD-ON, even a slight IVMP delay in IVMP by >3 days had a significant negative impact, whereas a moderate delay up to 7-9 days was permissible in MOGAD-ON. Female sex predicted poor recovery in MOGAD-ON, while older age hindered moderate recovery in NMOSD-ON and ION. CONCLUSION This comprehensive multicentre analysis on first-onset ON unveils subtype-specific prognostic factors. These insights will assist tailored treatment strategies and patient counselling for ON.
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Affiliation(s)
- Young Gi Min
- Department of Translational Medicine, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
- Department of Neurology, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Yeji Moon
- Department of Ophthalmology, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
| | - Young Nam Kwon
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
| | - Byung Joo Lee
- Department of Ophthalmology, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
| | - Kyung-Ah Park
- Department of Ophthalmology, Samsung Medical Center, Seoul, Korea (the Republic of)
| | - Jae Yong Han
- Institute of Vision Research, Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
| | - Jinu Han
- Institute of Vision Research, Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
| | - Haeng-Jin Lee
- Department of Ophthalmology, Jeonbuk National University Hospital, Jeonju, Korea (the Republic of)
| | - Seol-Hee Baek
- Department of Neurology, Korea University Anam Hospital, Seoul, Korea (the Republic of)
| | - Byung-Jo Kim
- Department of Neurology, Korea University Anam Hospital, Seoul, Korea (the Republic of)
| | - Jun-Soon Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea (the Republic of)
| | - Kyung Seok Park
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea (the Republic of)
| | - Nam-Hee Kim
- Department of Neurology, Dongguk University Ilsan Hospital, Ilsan, Korea (the Republic of)
| | - Martha Kim
- Department of Ophthalmology, Dongguk University Ilsan Hospital, Ilsan, Korea (the Republic of)
| | - Tai-Seung Nam
- Department of Neurology, Chonnam University Hospital, Hwasun, Korea (the Republic of)
| | - Seong-Il Oh
- Department of Neurology, Kyung Hee University Hospital, Seoul, Korea (the Republic of)
- Department of Neurology, Busan Paik Hospital, Busan, Korea (the Republic of)
| | - Jae Ho Jung
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
| | - Jung-Joon Sung
- Department of Translational Medicine, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
- Department of Neurology, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Myoung-Jin Jang
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Seong-Joon Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
| | - Sung-Min Kim
- Department of Translational Medicine, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
- Department of Neurology, Seoul National University Hospital, Seoul, Korea (the Republic of)
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Behbehani R, Ali A, Alakool A, Farouk S, Alroughani R. The clinical profile of new-onset optic neuritis in arabs, a tertiary center experience in Kuwait. Heliyon 2024; 10:e33985. [PMID: 39055848 PMCID: PMC11269862 DOI: 10.1016/j.heliyon.2024.e33985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 06/05/2024] [Accepted: 07/01/2024] [Indexed: 07/28/2024] Open
Abstract
Background Optic neuritis is an inflammatory disorder of the optic nerve and is often the initial manifestation of systemic demyelinating diseases such as multiple sclerosis (MS), neuromyelitis optic spectrum disorder (NMOSD), and myelin-oligodendrocyte glycoprotein (MOG) antibody-mediated disease. There are ethnic variations in the etiology of optic neuritis across the world. While multiple sclerosis is common in the West, NMOSD and MOG are more common causes in Asian patients. There is a paucity of reports on the clinical profile of optic neuritis in the Middle East. Objectives To study the demographic and clinical features of patients with new onset optic neuritis in a main tertiary care center. Methods A retrospective study of cases with new-onset optic neuritis at a tertiary care center between 2012 and 2022. The clinical and demographic characteristics were obtained from medical records and were summarized using descriptive statistics. Univariate analysis and multivariate analysis to assess the short-term visual outcome. Results Seventy-one patients with new-onset optic neuritis (70 unilateral and one bilateral) were included in the study. The mean age was 33.3 years, they were predominantly females (73 %), and most of the cases were MS (53 %) followed by idiopathic optic neuritis (42.3 %). Final visual acuity of at least 20/40 was seen in at least 91.5 %. Conclusion While the clinical profile of patients in this study closely resembles the Optic Neuritis Treatment Trial with a high incidence of MS and a good visual outcome in most patients and a good response to intravenous steroids, there is a significant proportion of idiopathic optic neuritis cases that may need to be better characterized with longer follow up and repeated serum biomarker testing.
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Affiliation(s)
- Raed Behbehani
- Al-Bahar Ophthalmology Center, Ibn Sina Hospital, Kuwait
| | - Abdullah Ali
- Al-Bahar Ophthalmology Center, Ibn Sina Hospital, Kuwait
| | - Ahmed Alakool
- Al-Bahar Ophthalmology Center, Ibn Sina Hospital, Kuwait
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Boccia VD, Boffa G, Lapucci C, Costagli M, Bosisio L, Mancardi MM, Inglese M, Cellerino M. Lesion phenotyping based on magnetic susceptibility in pediatric multiple sclerosis. J Neuroimaging 2024. [PMID: 39004778 DOI: 10.1111/jon.13221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 06/27/2024] [Accepted: 06/27/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND AND PURPOSE Pediatric multiple sclerosis (MS) displays different pathological features compared to adult MS, which can be studied in vivo by assessing tissue magnetic susceptibility with 3T-MRI. We aimed to assess different white matter lesions (WMLs) phenotypes in pediatric MS patients using quantitative susceptibility mapping (QSM) and susceptibility mapping weighted imaging (SMWI) over 12 months. METHODS Eleven pediatric MS patients [female: 63.6%; mean ± standard deviation (SD) age and disease duration: 16.3 ± 2.2 and 2.4 ± 1.5; median (range) Expanded Disability Status Scale (EDSS) 1 (0-2)] underwent 3 Tesla-MRI exams and EDSS assessments at baseline and after 1 year. QSM and SMWI were obtained using 3-dimensional (3D)-segmented echo-planar-imaging with submillimetric spatial resolution. WMLs were classified according to their QSM appearance and SMWI was used to identify QSM hyperintensities ascribable to veins. Total brain volumes at baseline and follow-up were computed using high-resolution 3D T1-weighted images. RESULTS Mean ± SD paramagnetic rim lesions (PRLs) prevalence was 7.0% ± 9.0. Fifty-four percent (6/11) of patients exhibited at least one PRL, with one patient exhibiting ≥ 4 PRLs. All patients showed QSM-iso-/hypo-intense lesions, which represented a mean ± SD of 65.8% ± 22.7 of total WMLs. QSM-hyperintense WMLs showed a positive correlation with total brain volume reduction at follow-up (r = 0.705; p = .02). No lesion was classified as different between baseline and follow-up. CONCLUSION Chronic compartmentalized inflammation seems to occur early in pediatric MS patients with short disease duration. A high prevalence of iso-/hypo-intense lesions was found, which could account for the higher remyelination potential in pediatric MS.
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Affiliation(s)
- Vincenzo Daniele Boccia
- Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Giacomo Boffa
- Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Caterina Lapucci
- Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mauro Costagli
- Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Luca Bosisio
- Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | | | - Matilde Inglese
- Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Maria Cellerino
- Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
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Iacono S, Schirò G, Salemi G, Scirè E, Aridon P, Melfa M, Andolina M, Sorbello G, Calì A, Brighina F, D’Amelio M, Ragonese P. Efficacy and Safety of Rescue Treatment with Plasma Exchange in Patients with Acute Inflammatory Neurological Disorders: A Single Center Experience. Neurol Int 2024; 16:761-775. [PMID: 39051217 PMCID: PMC11270162 DOI: 10.3390/neurolint16040056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 07/03/2024] [Accepted: 07/08/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Therapeutic plasma exchange (TPE) is a highly effective rescue treatment for patients with acute exacerbation of neuroimmunological disease that removes circulating autoantibodies and inflammatory components from the bloodstream. The aims of this study are to explore the safety and the effectiveness of TPE in patients with autoimmune neurological disorders. METHODS We retrospectively evaluated the frequency of adverse events (AEs) and the effectiveness of TPE using the modified Ranking Scale (mRS) in patients with acute neurological flares who underwent TPE at the University Hospital of Palermo. RESULTS Of 59 patients, the majority underwent TPE due to multiple sclerosis (MS) relapse. In 23.7% of cases, TPE was performed before obtaining a definite diagnosis due to the severity of the clinical presentation. After TPE, the mRS score was globally reduced (p < 0.0001), and this effect was marked in patients with MS, Guillain-Barré syndrome, and myasthenia gravis crisis but not in those with paraneoplastic syndromes. Circulating pathogenetic antibodies, younger age, and the early use of TPE were factors strongly associated with TPE effectiveness. The overall safety profile of TPE was satisfactory with an AE frequency of 15%. CONCLUSIONS These results highlight the early use of TPE in patients with circulating pathogenetic antibodies as well as its favorable safety profile.
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Affiliation(s)
- Salvatore Iacono
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90129 Palermo, Italy; (G.S.); (P.A.); (M.M.); (M.A.); (G.S.); (A.C.); (F.B.); (M.D.); (P.R.)
- Multiple Sclerosis Center, Foundation Institute G. Giglio, Cefalù, 90015 Palermo, Italy
| | - Giuseppe Schirò
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90129 Palermo, Italy; (G.S.); (P.A.); (M.M.); (M.A.); (G.S.); (A.C.); (F.B.); (M.D.); (P.R.)
- Multiple Sclerosis Center, Foundation Institute G. Giglio, Cefalù, 90015 Palermo, Italy
| | - Giuseppe Salemi
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90129 Palermo, Italy; (G.S.); (P.A.); (M.M.); (M.A.); (G.S.); (A.C.); (F.B.); (M.D.); (P.R.)
| | - Elisabetta Scirè
- Trasfusional Medicine Unit, University Hospital Policlinico P. Giaccone, 90129 Palermo, Italy;
| | - Paolo Aridon
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90129 Palermo, Italy; (G.S.); (P.A.); (M.M.); (M.A.); (G.S.); (A.C.); (F.B.); (M.D.); (P.R.)
| | - Michele Melfa
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90129 Palermo, Italy; (G.S.); (P.A.); (M.M.); (M.A.); (G.S.); (A.C.); (F.B.); (M.D.); (P.R.)
| | - Michele Andolina
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90129 Palermo, Italy; (G.S.); (P.A.); (M.M.); (M.A.); (G.S.); (A.C.); (F.B.); (M.D.); (P.R.)
| | - Gabriele Sorbello
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90129 Palermo, Italy; (G.S.); (P.A.); (M.M.); (M.A.); (G.S.); (A.C.); (F.B.); (M.D.); (P.R.)
| | - Andrea Calì
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90129 Palermo, Italy; (G.S.); (P.A.); (M.M.); (M.A.); (G.S.); (A.C.); (F.B.); (M.D.); (P.R.)
| | - Filippo Brighina
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90129 Palermo, Italy; (G.S.); (P.A.); (M.M.); (M.A.); (G.S.); (A.C.); (F.B.); (M.D.); (P.R.)
| | - Marco D’Amelio
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90129 Palermo, Italy; (G.S.); (P.A.); (M.M.); (M.A.); (G.S.); (A.C.); (F.B.); (M.D.); (P.R.)
| | - Paolo Ragonese
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90129 Palermo, Italy; (G.S.); (P.A.); (M.M.); (M.A.); (G.S.); (A.C.); (F.B.); (M.D.); (P.R.)
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Tzanetakos D, Tzartos JS, Velonakis G, Giannopoulos S, Tsivgoulis G. Neuromyelitis optica spectrum disorder-associated myelitis mimicking intramedullary neoplasm as a diagnostic pitfall: a case report. Neurol Sci 2024:10.1007/s10072-024-07684-5. [PMID: 38985372 DOI: 10.1007/s10072-024-07684-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 07/04/2024] [Indexed: 07/11/2024]
Affiliation(s)
- Dimitrios Tzanetakos
- Second Department of Neurology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
| | - John S Tzartos
- Second Department of Neurology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Velonakis
- Research Unit of Radiology, Second Department of Radiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Sotirios Giannopoulos
- Second Department of Neurology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Tsivgoulis
- Second Department of Neurology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA
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Schoeps VA, Virupakshaiah A, Waubant E. Unveiling the Performance of Proposed MOGAD Diagnostic Criteria. Neurology 2024; 103:e209551. [PMID: 38870485 DOI: 10.1212/wnl.0000000000209551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024] Open
Affiliation(s)
- Vinicius A Schoeps
- From the Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco
| | - Akash Virupakshaiah
- From the Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco
| | - Emmanuelle Waubant
- From the Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco
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Abboud H, Sun R, Modak N, Elkasaby M, Wang A, Levy M. Spinal movement disorders in NMOSD, MOGAD, and idiopathic transverse myelitis: a prospective observational study. J Neurol 2024:10.1007/s00415-024-12527-6. [PMID: 38977461 DOI: 10.1007/s00415-024-12527-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/13/2024] [Accepted: 06/15/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND Retrospective studies suggest that spinal movement disorders, especially tonic spasms, are prevalent in NMOSD. However, there have been no prospective studies evaluating spinal movement disorders in NMOSD, MOGAD, and idiopathic transverse myelitis (ITM). METHODS Patients referred to a tertiary neuroimmunology clinic for spinal cord demyelination (excluding MS) were evaluated. All patients answered a movement disorders survey and underwent a movement disorder-focused exam. Movement disorders were compared among patients with NMOSD with and without AQP4-IgG, MOGAD, and ITM. Patients with and without involuntary movements were also compared to identify predictors of spinal movement disorders. RESULTS Sixty-three patients were evaluated from 2017 to 2021 (71% females, median age 49 years, range 18-72 years, median disease duration 12 months, range 1-408). Of the total, 49% had ITM, 21% had NMOSD without AQP4-IgG, 19% had NMOSD with AQP4-IgG, and 11% had MOGAD. Movement disorders were present in 73% of the total patients and were most frequent in NMOSD with AQP4-IgG (92%) and least frequent in MOGAD (57%). The most frequent spinal movement disorders were tonic spasms (57%), focal dystonia (25%), spinal tremor (16%), spontaneous clonus (9.5%), secondary restless limb syndrome (9.5%), and spinal myoclonus (8%). Multivariate analysis showed that longitudinally extensive myelitis and AQP4-IgG are independent risk factors for the development of spinal movement disorders, while MOG-IgG and African American race were associated with a lower risk of developing these movement disorders. CONCLUSIONS Spinal movement disorders are highly prevalent in non-MS demyelinating disorders of the spinal cord. Prevalence rates exceed those reported in MS and retrospective NMOSD studies.
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Affiliation(s)
- Hesham Abboud
- Multiple Sclerosis and Neuroimmunology Program, University Hospitals Cleveland Medical Center, Bolwell, 5th Floor, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.
- Parkinson's and Movement Disorders Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
- Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| | - Rongyi Sun
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Nikhil Modak
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Mohamed Elkasaby
- Parkinson's and Movement Disorders Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Alexander Wang
- Parkinson's and Movement Disorders Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Michael Levy
- Division of Neuroimmunology and Neuroinfectious Diseases, Massachusetts General Hospital, Boston, MA, USA
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Wassmer E, Billaud C, Absoud M, Abdel-Mannan O, Benetou C, Cummins C, Forrest K, De Goede C, Eltantawi N, Hickson H, Hussain N, Jardine P, Livingston JH, Mordekar S, Ramdas S, Taylor M, Vijayakumar K, West S, Whitehouse WP, Kneen R, Hemingway C, Lim M, Hacohen Y, Wright S. Long term outcome in non-multiple sclerosis paediatric acquired demyelinating syndromes. Eur J Paediatr Neurol 2024; 52:52-58. [PMID: 39025036 DOI: 10.1016/j.ejpn.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 06/03/2024] [Accepted: 07/02/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVES We aimed to study the risks of relapse and long term disability in children with non-MS acquired demyelinating syndromes (ADS). METHODS In this prospective, multi-centre study, from the 14 UK pediatric neurology centres, children (<16 years) experiencing a first episode of ADS were recruited from 2010 to 2014. Case report forms were collected prospectively. RESULTS A total of 269 children were recruited and followed up for a median of 7.2 years. Median age at onset was 9y (IQR 9.5-14.5, 126 females). At last follow-up, 46 (18 %) had MS, 4 AQP4-Ab NMOSD and 206 (80 %) had other ADS, of which 27 (13 %) relapsed. Relapsing MOGAD was the diagnosis in 12/27, 6 were seronegative and 9 did not have antibodies tested. Frequency of relapse differed according to first presentation in non-MS ADS, being least likely in transverse myelitis (p = 0.025). In the non-MS group, MOG-Ab was predictive of relapse (HR = 8.42; p < 0.001) occurring 8 times as often decreasing over time. Long-term difficulties did not differ between children with monophasic vs relapsing diseases. CONCLUSION The risk of relapse in non-MS ADS depends on initial diagnosis, and MOG-Ab positivity. Long-term difficulties are observed regardless of relapses and are determined by presenting phenotype.
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Affiliation(s)
- Evangeline Wassmer
- Birmingham Children's Hospital, Birmingham, UK; Institute of Health and Neurodevelopment, Aston University, Birmingham, UK.
| | - Charly Billaud
- Institute of Health and Neurodevelopment, Aston University, Birmingham, UK
| | | | - Omar Abdel-Mannan
- Great Ormond Street Hospital, London, UK; Department of Neuroinflammation, Queen Square MS Centre, UCL Institute of Neurology, London, UK
| | | | | | - Katharine Forrest
- University Hospital Southampton, Southampton, UK; Royal Hospital for Children, Glasgow, UK
| | | | - Noha Eltantawi
- Birmingham Children's Hospital, Birmingham, UK; Manoura University, Egypt
| | - Helga Hickson
- Birmingham Children's Hospital, Birmingham, UK; Maidston and Tunbridge Wells, UK
| | | | - Phil Jardine
- University Hospital Bristol NHS Foundation Trust, Bristol, UK
| | | | | | | | | | - K Vijayakumar
- University Hospital Bristol NHS Foundation Trust, Bristol, UK; Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | | | - William P Whitehouse
- Nottingham University Hospitals, Nottingham, UK; University of Nottingham, Nottingham, UK
| | | | | | - Ming Lim
- Evelina London Children's Hospital, London, UK; Faculty of Life Sciences and Medicine, King's College, London, UK
| | - Yael Hacohen
- Great Ormond Street Hospital, London, UK; Department of Neuroinflammation, Queen Square MS Centre, UCL Institute of Neurology, London, UK
| | - Sukhvir Wright
- Birmingham Children's Hospital, Birmingham, UK; Institute of Health and Neurodevelopment, Aston University, Birmingham, UK
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Virupakshaiah A, Schoeps VA, Race J, Waltz M, Sharayah S, Nasr Z, Moseley CE, Zamvil SS, Gaudioso C, Schuette A, Casper TC, Rose J, Flanagan EP, Rodriguez M, Tillema JM, Chitnis T, Gorman MP, Graves JS, Benson LA, Rensel M, Abrams A, Krupp L, Lotze TE, Aaen G, Wheeler Y, Schreiner T, Waldman A, Chong J, Mar S, Waubant E. Predictors of a relapsing course in myelin oligodendrocyte glycoprotein antibody-associated disease. J Neurol Neurosurg Psychiatry 2024:jnnp-2024-333464. [PMID: 38964848 DOI: 10.1136/jnnp-2024-333464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/23/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a recently described demyelinating disorder, and children represent about 50% of all cases. Almost half of the patients experience relapses, but very few studies have evaluated predictors of relapse risk, challenging clinical management. The study aimed to identify predictors at MOGAD onset that are associated with a relapsing course. METHODS Prospectively collected data from paediatric patients with MOGAD seen by the US Network of Paediatric MS Centres were leveraged. Univariable and adjusted multivariable models were used to predict recurrent disease. RESULTS We identified 326 MOGAD cases (mean age at first event 8.9 years [SD 4.3], 57% female, 77% white and 74% non-Hispanic) and 46% relapsed during a mean follow-up of 3.9 years (SD 4.1). In the adjusted multivariable model, female sex (HR 1.66, 95% CI 1.17 to 2.36, p=0.004) and Hispanic/Latino ethnicity (HR 1.77, 95% CI 1.19 to 2.64, p=0.005) were associated with a higher risk of relapsing MOGAD. Maintenance treatment initiated before a second event with rituximab (HR 0.25, 95% CI 0.07 to 0.92, p=0.037) or intravenous immunoglobulin (IVIG) (HR 0.35, 95% CI 0.14 to 0.88, p=0.026) was associated with lower risk of a second event in multivariable analyses. Conversely, maintenance steroids were associated with a higher estimated relapse risk (HR 1.76, 95% CI 0.90 to 3.45, p=0.097). CONCLUSION Sex and ethnicity are associated with relapsing MOGAD. Use of rituximab or IVIG therapy shortly after onset is associated with a lower risk of the second event. Preventive treatment after a first event could be considered for those with a higher relapse risk.
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Affiliation(s)
- Akash Virupakshaiah
- Neurology, UCSF Weill Institute for Neurosciences, San Francisco, California, USA
| | - Vinicius A Schoeps
- Neurology, UCSF Weill Institute for Neurosciences, San Francisco, California, USA
| | | | | | - Siefaddeen Sharayah
- Department of Neurology, Washington University in St Louis, St Louis, Missouri, USA
| | - Zahra Nasr
- Neurology, UCSF Weill Institute for Neurosciences, San Francisco, California, USA
| | - Carson E Moseley
- Neurology, UCSF Weill Institute for Neurosciences, San Francisco, California, USA
| | - Scott S Zamvil
- Neurology, UCSF Weill Institute for Neurosciences, San Francisco, California, USA
- Program in Immunology, UCSF, San Francisco, California, USA
| | - Cristina Gaudioso
- Department of Neurology, Washington University in St Louis, St Louis, Missouri, USA
| | | | | | - John Rose
- The University of Utah, Salt Lake City, Utah, USA
| | | | | | | | - Tanuja Chitnis
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Mark P Gorman
- Boston Children's Hospital, Boston, Massachusetts, USA
| | - Jennifer S Graves
- Department of Neurology, University of California San Diego, La Jolla, California, USA
| | | | | | | | - Lauren Krupp
- Pediatric MS Center, NYU Langone Health, New York, New York, USA
| | | | - Gregory Aaen
- Loma Linda University Medical Center, Loma Linda, California, USA
| | - Yolanda Wheeler
- University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - Amy Waldman
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Janet Chong
- Neurology, UCSF Weill Institute for Neurosciences, San Francisco, California, USA
| | - Soe Mar
- Department of Neurology, Washington University in St Louis, St Louis, Missouri, USA
| | - Emmanuelle Waubant
- Neurology, UCSF Weill Institute for Neurosciences, San Francisco, California, USA
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Arnett S, Chew SH, Leitner U, Hor JY, Paul F, Yeaman MR, Levy M, Weinshenker BG, Banwell BL, Fujihara K, Abboud H, Dujmovic Basuroski I, Arrambide G, Neubrand VE, Quan C, Melamed E, Palace J, Sun J, Asgari N, Broadley SA. Sex ratio and age of onset in AQP4 antibody-associated NMOSD: a review and meta-analysis. J Neurol 2024:10.1007/s00415-024-12452-8. [PMID: 38958756 DOI: 10.1007/s00415-024-12452-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 05/15/2024] [Accepted: 05/16/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Aquaporin-4 (AQP4) antibody-associated neuromyelitis optica spectrum disorder (NMOSD) is an antibody-mediated inflammatory disease of the central nervous system. We have undertaken a systematic review and meta-analysis to ascertain the sex ratio and mean age of onset for AQP4 antibody associated NMOSD. We have also explored factors that impact on these demographic data. METHODS A systematic search of databases was conducted according to the PRISMA guidelines. Articles reporting sex distribution and age of onset for AQP4 antibody-associated NMSOD were reviewed. An initially inclusive approach involving exploration with regression meta-analysis was followed by an analysis of just AQP4 antibody positive cases. RESULTS A total of 528 articles were screened to yield 89 articles covering 19,415 individuals from 88 population samples. The female:male sex ratio was significantly influenced by the proportion of AQP4 antibody positive cases in the samples studied (p < 0.001). For AQP4 antibody-positive cases the overall estimate of the sex ratio was 8.89 (95% CI 7.78-10.15). For paediatric populations the estimate was 5.68 (95% CI 4.01-8.03) and for late-onset cases, it was 5.48 (95% CI 4.10-7.33). The mean age of onset was significantly associated with the mean life expectancy of the population sampled (p < 0.001). The mean age of onset for AQP4 antibody-positive cases in long-lived populations was 41.7 years versus 33.3 years in the remainder. CONCLUSIONS The female:male sex ratio and the mean age of onset of AQP4 antibody-associated NMOSD are significantly higher than MS. The sex ratio increases with the proportion of cases that are positive for AQP4 antibodies and the mean age of onset increases with population life expectancy.
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Affiliation(s)
- Simon Arnett
- School of Medicine and Dentistry, Gold Coast Campus, Griffith University, Gold Coast, QLD, 4222, Australia.
- Department of Neurology, Gold Coast University Hospital, Southport, QLD, Australia.
| | - Sin Hong Chew
- School of Medicine and Dentistry, Gold Coast Campus, Griffith University, Gold Coast, QLD, 4222, Australia
- Department of Neurology, Gold Coast University Hospital, Southport, QLD, Australia
| | - Unnah Leitner
- School of Medicine and Dentistry, Gold Coast Campus, Griffith University, Gold Coast, QLD, 4222, Australia
| | - Jyh Yung Hor
- Department of Neurology, Penang General Hospital, George Town, Penang, Malaysia
| | - Friedemann Paul
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Michael R Yeaman
- Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA
- Department of Medicine, Divisions of Molecular Medicine & Infectious Diseases, Harbor-UCLA Medical Center, Torrance, CA, USA
- Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Michael Levy
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Brenda L Banwell
- Division of Child Neurology, Children's Hospital of Philadelphia, Department of Neurology and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kazuo Fujihara
- Department of Multiple Sclerosis Therapeutics, Fukushima Medical University and Multiple Sclerosis and Neuromyelitis Optica Center, Southern Tohoku Research Institute for Neuroscience, Koriyama, Japan
| | - Hesham Abboud
- Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | | | - Georgina Arrambide
- Neurology-Neuroimmunology Department, Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Catalonia, Spain
| | - Veronika E Neubrand
- Department of Cell Biology, Faculty of Sciences, University of Granada, Granada, Spain
| | - Chao Quan
- Department of Neurology, The National Centre for Neurological Disorders, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Esther Melamed
- Dell Medical School, University of Texas, Austin, TX, USA
| | - Jacqueline Palace
- Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, UK
- Department Clinical Neurology, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| | - Jing Sun
- School of Medicine and Dentistry, Gold Coast Campus, Griffith University, Gold Coast, QLD, 4222, Australia
- Institute of Integrated Intelligence and Systems, Nathan Campus, Griffith University, Nathan, QLD, Australia
- Rural Health Research Institute, Charles Sturt University, Bathurst, NSW, Australia
| | - Nasrin Asgari
- Department of Neurology, Slagelse Hospital, Slagelse, Denmark
- Institutes of Regional Health Research and Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Simon A Broadley
- School of Medicine and Dentistry, Gold Coast Campus, Griffith University, Gold Coast, QLD, 4222, Australia
- Department of Neurology, Gold Coast University Hospital, Southport, QLD, Australia
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Duvigneaud Z, Lardeux P, Verrecchia S, Benyahya L, Marignier R, Froment Tilikete C. Diagnostic criteria for optic neuritis in the acute and subacute phase: clinical uses and limitations. J Neurol 2024:10.1007/s00415-024-12540-9. [PMID: 38954036 DOI: 10.1007/s00415-024-12540-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 06/21/2024] [Accepted: 06/23/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND A recent international consensus panel proposed diagnostic criteria for optic neuritis and a new classification. We aimed to investigate the clinical relevance of these diagnostic criteria and classification, in a cohort of patients hospitalized for a suspected diagnosis of optic neuritis. METHODS We included all patients hospitalized between 2017 and 2022 in our tertiary center for (sub)acute loss of visual acuity suggestive of optic neuritis. Clinical and paraclinical criteria obtained within the first 3 months of symptoms were collected, as well as the final diagnosis which could be optic neuritis or non-optic neuritis. We constructed a contingency table comparing diagnoses based on physician experience to those based on the recently proposed criteria. The subtypes of optic neuritis based on the new classification were compared to subtypes based on the clinician experience. RESULTS Two hundred fifty-seven patients were included in this study. Prevalence of optic neuritis in our cohort was 88.3%. Sensitivity and specificity of a correct diagnosis using the new criteria were, respectively, 99.5% and 86.7%. The proposed diagnostic criteria overdiagnosed four patients with optic neuritis and missed the diagnosis in one patient. According to the recent classification, idiopathic optic neuritis and clinical isolated syndrome were reclassified mainly as single isolated optic neuritis. CONCLUSION In our specific cohort of patients hospitalized for acute and subacute optic neuropathy highly suspect of optic neuritis, we found that recently proposed diagnostic criteria and classification of optic neuritis are relevant for our clinical practice. Our interpretation of clinical requirement for definite and possible optic neuritis diagnosis might explain our excellent sensitivity and our high percentage of definite optic neuritis, relative to previous publications. The moderate specificity (86.7%) underlines the importance to include all contextual data in consideration for the diagnosis. The simplification of subgroups is useful, but our study highlights the complexity to find the adequate subgroup for seronegative NMOSD.
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Affiliation(s)
- Z Duvigneaud
- Neuro-Ophthalmology Unit, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - P Lardeux
- Neuro-Ophthalmology Unit, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - S Verrecchia
- Neuro-Ophthalmology Unit, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - L Benyahya
- Centre de Référence Des Maladies Inflammatoires Rares du Cerveau et de La Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - R Marignier
- Centre de Référence Des Maladies Inflammatoires Rares du Cerveau et de La Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
- Lyon Neuroscience Research Center, INSERM 1028 et CNRS UMR5292 and Université Claude Bernard Lyon 1, Lyon, France
| | - C Froment Tilikete
- Neuro-Ophthalmology Unit, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.
- Lyon Neuroscience Research Center, INSERM 1028 et CNRS UMR5292 and Université Claude Bernard Lyon 1, Lyon, France.
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Samadzadeh S, Adnan R, Berglova P, Barzegar M, Debrabant B, Roikjaer SG, Levy M, Petzold A, Palace J, Flanagan EP, Mariotto S, Skou ST, Froelich A, Lotan I, Messina S, Geraldes R, Asseyer S, Stiebel-Kalish H, Oertel FC, Shaygannejad V, Sahraian MA, Kim HJ, Bennett JL, Böttcher C, Zimmermann HG, Weinshenker BG, Paul F, Asgari N. Protocol of a prospective multicenter study on comorbidity impact on multiple sclerosis and antibody-mediated diseases of the central nervous system (COMMIT). Front Immunol 2024; 15:1380025. [PMID: 39021565 PMCID: PMC11253107 DOI: 10.3389/fimmu.2024.1380025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 06/05/2024] [Indexed: 07/20/2024] Open
Abstract
Comorbidities in patients with multiple sclerosis (MS) and antibody-mediated diseases of the central nervous system (CNS) including neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein (MOG)-antibody-associated disease (MOGAD) are common and may influence the course of their neurological disease. Comorbidity may contribute to neuronal injury and therefore limit recovery from attacks, accelerate disease progression, and increase disability. This study aims to explore the impact of comorbidity, particularly vascular comorbidity, and related risk factors on clinical and paraclinical parameters of MS, NMOSD and MOGAD. We propose COMMIT, a prospective multicenter study with longitudinal follow-up of patients with MS, NMOSD, and MOGAD, with or without comorbidities, as well as healthy subjects as controls. Subjects will be stratified by age, sex and ethnicity. In consecutive samples we will analyze levels of inflammation and neurodegeneration markers in both fluid and cellular compartments of the peripheral blood and cerebrospinal fluid (CSF) using multiple state-of-the-art technologies, including untargeted proteomics and targeted ultrasensitive ELISA assays and quantitative reverse transcription polymerase chain reaction (RT-qPCR) as well as high-dimensional single-cell technologies i.e., mass cytometry and single-cell RNA sequencing. Algorithm-based data analyses will be used to unravel the relationship between these markers, optical coherence tomography (OCT) and magnetic resonance imaging (MRI), and clinical outcomes including frequency and severity of relapses, long-term disability, and quality of life. The goal is to evaluate the impact of comorbidities on MS, NMOSD, and MOGAD which may lead to development of treatment approaches to improve outcomes of inflammatory demyelinating diseases of the CNS.
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Affiliation(s)
- Sara Samadzadeh
- Institute of Regional Health Research and, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- The Center for Neurological Research, Department of Neurology Slagelse Hospital, Slagelse, Denmark
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Experimental and Clinical Research Center, Berlin, Germany
| | - Rafl Adnan
- Institute of Regional Health Research and, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- The Center for Neurological Research, Department of Neurology Slagelse Hospital, Slagelse, Denmark
| | - Paulina Berglova
- The Center for Neurological Research, Department of Neurology Slagelse Hospital, Slagelse, Denmark
| | - Mahdi Barzegar
- Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Birgit Debrabant
- Department of Mathematics and Computer Science, Faculty of Natural Sciences, University of Southern Denmark, Odense, Denmark
| | - Stine Gundtoft Roikjaer
- Institute of Regional Health Research and, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- The Center for Neurological Research, Department of Neurology Slagelse Hospital, Slagelse, Denmark
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
| | - Michael Levy
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Axel Petzold
- The National Hospital for Neurology and Neurosurgery, and Moorfields Eye Hospital and Queen Square University College London (UCL), Institute of Neurology, London, United Kingdom
- Department of Neurology, Amsterdam The University Medical Center Utrecht (UMC), Amsterdam, Netherlands
- Department of Ophthalmology, Amsterdam The University Medical Center Utrecht (UMC), Amsterdam, Netherlands
| | - Jacqueline Palace
- Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, National Health Service Trust, Oxford, United Kingdom
| | - Eoin P. Flanagan
- Department Neurology and Center for Multiple Sclerosis (MS), and Autoimmune Neurology, Mayo Clinic, Rochester, MN, United States
| | - Sara Mariotto
- Neurology Unit, Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
| | - Soeren T. Skou
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Anne Froelich
- The Center for Neurological Research, Department of Neurology Slagelse Hospital, Slagelse, Denmark
- Innovation and Research Centre for Multimorbidity, Slagelse Hospital, Slagelse, Denmark
- Section of General Practice, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Itay Lotan
- Department of Neurology and Neuroimmunology Unit, Rabin Medical Center, Petah Tikva, Israel
- Tel Aviv University Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Silvia Messina
- Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, National Health Service Trust, Oxford, United Kingdom
| | - Ruth Geraldes
- Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, National Health Service Trust, Oxford, United Kingdom
| | - Susanna Asseyer
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Experimental and Clinical Research Center, Berlin, Germany
- Experimental and Clinical Research Center, a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
- NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Hadas Stiebel-Kalish
- Tel Aviv University Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Neuro-Ophthalmology Unit, Rabin Medical Center, Petah Tikva, Israel
- Eye Laboratory, Felsenstein Research Institute, Tel Aviv, Israel
| | - Frederike Cosima Oertel
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Experimental and Clinical Research Center, Berlin, Germany
- Experimental and Clinical Research Center, a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
- NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Vahid Shaygannejad
- Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Ali Sahraian
- Multiple Sclerosis (MS) Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ho Jin Kim
- Department of Neurology, Research Institute and Hospital of National Cancer Center, Goyang, Republic of Korea
| | - Jeffrey L. Bennett
- Department of Neurology and Ophthalmology, Programs in Neuroscience and Immunology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Chotima Böttcher
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Experimental and Clinical Research Center, Berlin, Germany
- Experimental and Clinical Research Center, a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Hanna G. Zimmermann
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Experimental and Clinical Research Center, Berlin, Germany
- Experimental and Clinical Research Center, a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
- NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Einstein Center Digital Future, Berlin, Germany
| | - Brian G. Weinshenker
- Department of Neurology, University of Virginia, Charlottesville, VA, United States
| | - Friedemann Paul
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Experimental and Clinical Research Center, Berlin, Germany
- Experimental and Clinical Research Center, a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
- NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Nasrin Asgari
- Institute of Regional Health Research and, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- The Center for Neurological Research, Department of Neurology Slagelse Hospital, Slagelse, Denmark
- Open Patient data Explorative Network, Odense University Hospital, University of Southern Denmark, Odense, Denmark
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Virupakshaiah A, Moseley CE, Elicegui S, Gerwitz LM, Spencer CM, George E, Shah M, Cree BAC, Waubant E, Zamvil SS. Life-Threatening MOG Antibody-Associated Hemorrhagic ADEM With Elevated CSF IL-6. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2024; 11:e200243. [PMID: 38630950 PMCID: PMC11087044 DOI: 10.1212/nxi.0000000000200243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 02/14/2024] [Indexed: 04/19/2024]
Abstract
Acute disseminated encephalomyelitis (ADEM) is one characteristic manifestation of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). A previously healthy man presented with retro-orbital headache and urinary retention 14 days after Tdap vaccination. Brain and spine MRI suggested a CNS demyelinating process. Despite treatment with IV steroids, he deteriorated, manifesting hemiparesis and later impaired consciousness, requiring intubation. A repeat brain MRI demonstrated new bilateral supratentorial lesions associated with venous sinus thrombosis, hemorrhage, and midline shift. Anti-MOG antibody was present at a high titer. CSF IL-6 protein was >2,000 times above the upper limits of normal. He improved after plasma exchange, then began monthly treatment alone with anti-IL-6 receptor antibody, tocilizumab, and has remained stable. This case highlights how adult-onset MOGAD, like childhood ADEM, can rapidly become life-threatening. The markedly elevated CSF IL-6 observed here supports consideration for evaluating CSF cytokines more broadly in patients with acute MOGAD.
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Affiliation(s)
- Akash Virupakshaiah
- From the UCSF Weill Institute for Neurosciences (A.V., C.E.M., C.M.S., M.S., B.A.C., E.W., S.S.Z.), University of California, San Francisco; University of Nevada Reno School of Medicine (S.E.); Renown Health (L.M.G.), Reno, NV; Department of Radiology and Biomedical Imaging (E.G.); and Program in Immunology (S.S.Z.), University of California, San Francisco
| | - Carson E Moseley
- From the UCSF Weill Institute for Neurosciences (A.V., C.E.M., C.M.S., M.S., B.A.C., E.W., S.S.Z.), University of California, San Francisco; University of Nevada Reno School of Medicine (S.E.); Renown Health (L.M.G.), Reno, NV; Department of Radiology and Biomedical Imaging (E.G.); and Program in Immunology (S.S.Z.), University of California, San Francisco
| | - Steven Elicegui
- From the UCSF Weill Institute for Neurosciences (A.V., C.E.M., C.M.S., M.S., B.A.C., E.W., S.S.Z.), University of California, San Francisco; University of Nevada Reno School of Medicine (S.E.); Renown Health (L.M.G.), Reno, NV; Department of Radiology and Biomedical Imaging (E.G.); and Program in Immunology (S.S.Z.), University of California, San Francisco
| | - Lee M Gerwitz
- From the UCSF Weill Institute for Neurosciences (A.V., C.E.M., C.M.S., M.S., B.A.C., E.W., S.S.Z.), University of California, San Francisco; University of Nevada Reno School of Medicine (S.E.); Renown Health (L.M.G.), Reno, NV; Department of Radiology and Biomedical Imaging (E.G.); and Program in Immunology (S.S.Z.), University of California, San Francisco
| | - Collin M Spencer
- From the UCSF Weill Institute for Neurosciences (A.V., C.E.M., C.M.S., M.S., B.A.C., E.W., S.S.Z.), University of California, San Francisco; University of Nevada Reno School of Medicine (S.E.); Renown Health (L.M.G.), Reno, NV; Department of Radiology and Biomedical Imaging (E.G.); and Program in Immunology (S.S.Z.), University of California, San Francisco
| | - Elizabeth George
- From the UCSF Weill Institute for Neurosciences (A.V., C.E.M., C.M.S., M.S., B.A.C., E.W., S.S.Z.), University of California, San Francisco; University of Nevada Reno School of Medicine (S.E.); Renown Health (L.M.G.), Reno, NV; Department of Radiology and Biomedical Imaging (E.G.); and Program in Immunology (S.S.Z.), University of California, San Francisco
| | - Maulik Shah
- From the UCSF Weill Institute for Neurosciences (A.V., C.E.M., C.M.S., M.S., B.A.C., E.W., S.S.Z.), University of California, San Francisco; University of Nevada Reno School of Medicine (S.E.); Renown Health (L.M.G.), Reno, NV; Department of Radiology and Biomedical Imaging (E.G.); and Program in Immunology (S.S.Z.), University of California, San Francisco
| | - Bruce A C Cree
- From the UCSF Weill Institute for Neurosciences (A.V., C.E.M., C.M.S., M.S., B.A.C., E.W., S.S.Z.), University of California, San Francisco; University of Nevada Reno School of Medicine (S.E.); Renown Health (L.M.G.), Reno, NV; Department of Radiology and Biomedical Imaging (E.G.); and Program in Immunology (S.S.Z.), University of California, San Francisco
| | - Emmanuelle Waubant
- From the UCSF Weill Institute for Neurosciences (A.V., C.E.M., C.M.S., M.S., B.A.C., E.W., S.S.Z.), University of California, San Francisco; University of Nevada Reno School of Medicine (S.E.); Renown Health (L.M.G.), Reno, NV; Department of Radiology and Biomedical Imaging (E.G.); and Program in Immunology (S.S.Z.), University of California, San Francisco
| | - Scott S Zamvil
- From the UCSF Weill Institute for Neurosciences (A.V., C.E.M., C.M.S., M.S., B.A.C., E.W., S.S.Z.), University of California, San Francisco; University of Nevada Reno School of Medicine (S.E.); Renown Health (L.M.G.), Reno, NV; Department of Radiology and Biomedical Imaging (E.G.); and Program in Immunology (S.S.Z.), University of California, San Francisco
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Syc-Mazurek SB, Zhao-Fleming H, Guo Y, Tisavipat N, Chen JJ, Zekeridou A, Kournoutas I, Orme JJ, Block MS, Lucchinetti CF, Mustafa R, Flanagan EP. MOG Antibody-Associated Disease in the Setting of Metastatic Melanoma Complicated by Immune Checkpoint Inhibitor Use. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2024; 11:e200249. [PMID: 38696737 PMCID: PMC11068306 DOI: 10.1212/nxi.0000000000200249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 03/13/2024] [Indexed: 05/04/2024]
Abstract
OBJECTIVES Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an autoimmune demyelinating disease rarely associated with malignancy. We report the clinical, MRI, immunopathology, and treatment response in a person with MOGAD and melanoma. METHODS This is a case report of a person with a multidisciplinary evaluation at a tertiary referral center. RESULTS A 52-year-old man presented with progressive encephalomyelitis that led to identification of metastatic melanoma. Investigations revealed positive MOG-IgG at high titers in serum (1:1,000; normal, <1:20) and CSF (1:4,096; normal, <1:2). MRI demonstrated multifocal T2 lesions with enhancement in the brain and spine. Brain biopsy showed demyelination and inflammation. MOG immunostaining was not present in the tumor tissue. He initially improved with methylprednisolone, plasmapheresis, prolonged oral steroid taper, and cancer-directed treatment with BRAF and MEK 1/2 inhibitors, but then developed bilateral optic neuritis. IV immunoglobulin (IVIG) was initiated. Five months later, he developed metastases and immune checkpoint inhibitor (ICI) treatment was started, which precipitated optic neuritis and myelitis despite IVIG and prednisone. Tocilizumab, an interleukin-6 receptor blocker, was started with excellent and sustained clinical and radiologic response. DISCUSSION This case revealed a presentation of MOGAD concurrent with melanoma without tumor MOG immunostaining. We highlight tocilizumab as a dual-purpose treatment of MOGAD and the neurologic immune-related adverse effect of ICI.
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Affiliation(s)
- Stephanie B Syc-Mazurek
- From the Departments of Neurology (S.B.S.-M., H.Z.-F., Y.G., N.T., J.J.C., A.Z., C.F.L., R.M., E.P.F.), Ophthalmology (J.J.C.), Internal Medicine (I.K.), and Oncology (J.J.O., M.S.B.), Mayo Clinic, Rochester, MN; and Neurology (C.F.L.), University of Texas at Austin
| | - Hannah Zhao-Fleming
- From the Departments of Neurology (S.B.S.-M., H.Z.-F., Y.G., N.T., J.J.C., A.Z., C.F.L., R.M., E.P.F.), Ophthalmology (J.J.C.), Internal Medicine (I.K.), and Oncology (J.J.O., M.S.B.), Mayo Clinic, Rochester, MN; and Neurology (C.F.L.), University of Texas at Austin
| | - Yong Guo
- From the Departments of Neurology (S.B.S.-M., H.Z.-F., Y.G., N.T., J.J.C., A.Z., C.F.L., R.M., E.P.F.), Ophthalmology (J.J.C.), Internal Medicine (I.K.), and Oncology (J.J.O., M.S.B.), Mayo Clinic, Rochester, MN; and Neurology (C.F.L.), University of Texas at Austin
| | - Nanthaya Tisavipat
- From the Departments of Neurology (S.B.S.-M., H.Z.-F., Y.G., N.T., J.J.C., A.Z., C.F.L., R.M., E.P.F.), Ophthalmology (J.J.C.), Internal Medicine (I.K.), and Oncology (J.J.O., M.S.B.), Mayo Clinic, Rochester, MN; and Neurology (C.F.L.), University of Texas at Austin
| | - John J Chen
- From the Departments of Neurology (S.B.S.-M., H.Z.-F., Y.G., N.T., J.J.C., A.Z., C.F.L., R.M., E.P.F.), Ophthalmology (J.J.C.), Internal Medicine (I.K.), and Oncology (J.J.O., M.S.B.), Mayo Clinic, Rochester, MN; and Neurology (C.F.L.), University of Texas at Austin
| | - Anastasia Zekeridou
- From the Departments of Neurology (S.B.S.-M., H.Z.-F., Y.G., N.T., J.J.C., A.Z., C.F.L., R.M., E.P.F.), Ophthalmology (J.J.C.), Internal Medicine (I.K.), and Oncology (J.J.O., M.S.B.), Mayo Clinic, Rochester, MN; and Neurology (C.F.L.), University of Texas at Austin
| | - Ioannis Kournoutas
- From the Departments of Neurology (S.B.S.-M., H.Z.-F., Y.G., N.T., J.J.C., A.Z., C.F.L., R.M., E.P.F.), Ophthalmology (J.J.C.), Internal Medicine (I.K.), and Oncology (J.J.O., M.S.B.), Mayo Clinic, Rochester, MN; and Neurology (C.F.L.), University of Texas at Austin
| | - Jacob J Orme
- From the Departments of Neurology (S.B.S.-M., H.Z.-F., Y.G., N.T., J.J.C., A.Z., C.F.L., R.M., E.P.F.), Ophthalmology (J.J.C.), Internal Medicine (I.K.), and Oncology (J.J.O., M.S.B.), Mayo Clinic, Rochester, MN; and Neurology (C.F.L.), University of Texas at Austin
| | - Matthew S Block
- From the Departments of Neurology (S.B.S.-M., H.Z.-F., Y.G., N.T., J.J.C., A.Z., C.F.L., R.M., E.P.F.), Ophthalmology (J.J.C.), Internal Medicine (I.K.), and Oncology (J.J.O., M.S.B.), Mayo Clinic, Rochester, MN; and Neurology (C.F.L.), University of Texas at Austin
| | - Claudia F Lucchinetti
- From the Departments of Neurology (S.B.S.-M., H.Z.-F., Y.G., N.T., J.J.C., A.Z., C.F.L., R.M., E.P.F.), Ophthalmology (J.J.C.), Internal Medicine (I.K.), and Oncology (J.J.O., M.S.B.), Mayo Clinic, Rochester, MN; and Neurology (C.F.L.), University of Texas at Austin
| | - Rafid Mustafa
- From the Departments of Neurology (S.B.S.-M., H.Z.-F., Y.G., N.T., J.J.C., A.Z., C.F.L., R.M., E.P.F.), Ophthalmology (J.J.C.), Internal Medicine (I.K.), and Oncology (J.J.O., M.S.B.), Mayo Clinic, Rochester, MN; and Neurology (C.F.L.), University of Texas at Austin
| | - Eoin P Flanagan
- From the Departments of Neurology (S.B.S.-M., H.Z.-F., Y.G., N.T., J.J.C., A.Z., C.F.L., R.M., E.P.F.), Ophthalmology (J.J.C.), Internal Medicine (I.K.), and Oncology (J.J.O., M.S.B.), Mayo Clinic, Rochester, MN; and Neurology (C.F.L.), University of Texas at Austin
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Estrela T, Stiebel-Kalish H, Rettenmaier L, Henderson AD, Sotirchos E, Said Y, Ahmadi G, Tajfirouz DA, Flanagan EP, Tisavipat N, Gise R, Chwalisz BK, Chen JJ. Optic Disc Cupping in Neuromyelitis Optica Spectrum Disorder, Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease, and Multiple Sclerosis and Its Relationship With Optical Coherence Tomography Parameters: A Multicenter Study. J Neuroophthalmol 2024:00041327-990000000-00675. [PMID: 38946028 DOI: 10.1097/wno.0000000000002204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
BACKGROUND Although cupping of the optic nerve is classically a sign of glaucomatous optic neuropathy, it has been shown that cupping can sometimes occur after an episode of optic neuritis (ON). The purpose of this study was to compare cupping in patients after ON from multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), or myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) and to investigate the relationship between cupping and retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thinning. METHODS This was a retrospective cohort involving patients (≥18 years) with ON from 3 institutions. Patients were eligible if they had optical coherence tomography (Cirrus, OCT) performed ≥6 months after a single unilateral ON. The amount of thinning and cupping was estimated from the difference in the OCT parameters between affected and unaffected eyes. Univariable and multivariable regressions were used to investigate the relationship between cupping and ON etiology. Pearson correlation was used to investigate the relationship between cupping and RNFL and GCC. RESULTS Eighty-six subjects (MS: 35, NMOSD: 26, and MOGAD: 25) were included. There was no significant difference in gender and race between the groups, and most patients (86.1%) were female. Patients with NMOSD were significantly older than patients with MS or MOGAD (P = 0.002). In the univariate model, cupping was significantly higher in the NMOSD group (P = 0.017); however, after adjusting for age, GCC, and RNFL of the affected eye, the difference was no longer statistically significant (P = 0.949). The correlation between cupping asymmetry and RNFL and GCC of the affected eye was inversely strong in patients with MS (R = -0.60 and R = -0.64, respectively), inversely moderate in patients with MOGAD (R = -0.34 and R = -0.40, respectively), and weak in patients with NMOSD (R = -0.03 and R = -0.17, respectively). CONCLUSIONS Our results demonstrated that cupping after ON is correlated with RNFL and GCC thinning; although cupping was overall greater in the NMOSD group, once adjusted for age, RNFL, and GCC, it did not differ among patients with MS, NMOSD, and MOGAD.
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Affiliation(s)
- Tais Estrela
- Department of Ophthalmology (TE, BKC), Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology (TE, RG), Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; Neuro-Ophthalmology Unit, Felsenstein Medical Research Center and Department of Ophthalmology (HS-K), Rabin Medical Center, Petah Tikva, Israel, and Tel Aviv University, Tel Aviv, Israel; Department of Neurology (LR, BKC), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Division of Neuro-Ophthalmology (ADH), Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Neurology (ES, YS, GA), Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Neurology (DAT, EPF, NT, JJC), Mayo Clinic, Rochester, Minnesota; and Departments of Ophthalmology and Neurology (JJC), Mayo Clinic, Rochester, Minnesota
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Gawde S, Siebert N, Ruprecht K, Kumar G, Ko RM, Massey K, Guthridge JM, Mao-Draayer Y, Schindler P, Hastermann M, Pardo G, Paul F, Axtell RC. Serum Proteomics Distinguish Subtypes of NMO Spectrum Disorder and MOG Antibody-Associated Disease and Highlight Effects of B-Cell Depletion. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2024; 11:e200268. [PMID: 38885457 PMCID: PMC11186702 DOI: 10.1212/nxi.0000000000200268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/15/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND AND OBJECTIVES AQP4 antibody-positive NMOSD (AQP4-NMOSD), MOG antibody-associated disease (MOGAD), and seronegative NMOSD (SN-NMOSD) are neuroautoimmune conditions that have overlapping clinical manifestations. Yet, important differences exist in these diseases, particularly in B-cell depletion (BCD) efficacy. Yet, the biology driving these differences remains unclear. Our study aims to clarify biological pathways distinguishing these diseases beyond autoantibodies and investigate variable BCD effects through proteomic comparisons. METHODS In a retrospective study, 1,463 serum proteins were measured in 53 AQP4-NMOSD, 25 MOGAD, 18 SN-NMOSD, and 49 healthy individuals. To identify disease subtype-associated signatures, we examined serum proteins in patients without anti-CD20 B-cell depletion (NoBCD). We then assessed the effect of BCD treatment within each subtype by comparing proteins between BCD-treated and NoBCD-treated patients. RESULTS In NoBCD-treated patients, serum profiles distinguished the 3 diseases. AQP4-NMOSD showed elevated type I interferon-induced chemokines (CXCL9 and CXCL10) and TFH chemokine (CXCL13). MOGAD exhibited increased cytotoxic T-cell proteases (granzyme B and granzyme H), while SN-NMOSD displayed elevated Wnt inhibitory factor 1, a marker for nerve injury. Across all subtypes, BCD-treated patients showed reduction of B-cell-associated proteins. In AQP4-NMOSD, BCD led to a decrease in several inflammatory pathways, including IL-17 signaling, cytokine storm, and macrophage activation. By contrast, BCD elevated these pathways in patients with MOGAD. BCD had no effect on these pathways in SN-NMOSD. DISCUSSION Proteomic profiles show unique biological pathways that distinguish AQP4-NMOSD, MOGAD, or SN-NMOSD. Furthermore, BCD uniquely affects inflammatory pathways in each disease type, providing an explanation for the disparate therapeutic response in AQP4-NMOSD and MOGAD.
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Affiliation(s)
- Saurabh Gawde
- From the Arthritis and Clinical Immunology Research Program (S.G., G.K., R.M.K., K.M., J.M.G., Y.M.-D., G.P., R.C.A.), Oklahoma Medical Research Foundation; Department of Microbiology and Immunology (S.G., R.C.A.), Oklahoma University Health Science Center; NeuroCure Clinical Research Center and Experimental and Clinical Research Center (N.S., K.R., P.S., M.H., F.P.), Max Delbrueck Center for Molecular Medicine and Charité Universitätsmedizin Berlin; and Department of Neurology (N.S., K.R., P.S., M.H., F.P.), Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany
| | - Nadja Siebert
- From the Arthritis and Clinical Immunology Research Program (S.G., G.K., R.M.K., K.M., J.M.G., Y.M.-D., G.P., R.C.A.), Oklahoma Medical Research Foundation; Department of Microbiology and Immunology (S.G., R.C.A.), Oklahoma University Health Science Center; NeuroCure Clinical Research Center and Experimental and Clinical Research Center (N.S., K.R., P.S., M.H., F.P.), Max Delbrueck Center for Molecular Medicine and Charité Universitätsmedizin Berlin; and Department of Neurology (N.S., K.R., P.S., M.H., F.P.), Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany
| | - Klemens Ruprecht
- From the Arthritis and Clinical Immunology Research Program (S.G., G.K., R.M.K., K.M., J.M.G., Y.M.-D., G.P., R.C.A.), Oklahoma Medical Research Foundation; Department of Microbiology and Immunology (S.G., R.C.A.), Oklahoma University Health Science Center; NeuroCure Clinical Research Center and Experimental and Clinical Research Center (N.S., K.R., P.S., M.H., F.P.), Max Delbrueck Center for Molecular Medicine and Charité Universitätsmedizin Berlin; and Department of Neurology (N.S., K.R., P.S., M.H., F.P.), Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany
| | - Gaurav Kumar
- From the Arthritis and Clinical Immunology Research Program (S.G., G.K., R.M.K., K.M., J.M.G., Y.M.-D., G.P., R.C.A.), Oklahoma Medical Research Foundation; Department of Microbiology and Immunology (S.G., R.C.A.), Oklahoma University Health Science Center; NeuroCure Clinical Research Center and Experimental and Clinical Research Center (N.S., K.R., P.S., M.H., F.P.), Max Delbrueck Center for Molecular Medicine and Charité Universitätsmedizin Berlin; and Department of Neurology (N.S., K.R., P.S., M.H., F.P.), Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany
| | - Rose M Ko
- From the Arthritis and Clinical Immunology Research Program (S.G., G.K., R.M.K., K.M., J.M.G., Y.M.-D., G.P., R.C.A.), Oklahoma Medical Research Foundation; Department of Microbiology and Immunology (S.G., R.C.A.), Oklahoma University Health Science Center; NeuroCure Clinical Research Center and Experimental and Clinical Research Center (N.S., K.R., P.S., M.H., F.P.), Max Delbrueck Center for Molecular Medicine and Charité Universitätsmedizin Berlin; and Department of Neurology (N.S., K.R., P.S., M.H., F.P.), Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany
| | - Kaylea Massey
- From the Arthritis and Clinical Immunology Research Program (S.G., G.K., R.M.K., K.M., J.M.G., Y.M.-D., G.P., R.C.A.), Oklahoma Medical Research Foundation; Department of Microbiology and Immunology (S.G., R.C.A.), Oklahoma University Health Science Center; NeuroCure Clinical Research Center and Experimental and Clinical Research Center (N.S., K.R., P.S., M.H., F.P.), Max Delbrueck Center for Molecular Medicine and Charité Universitätsmedizin Berlin; and Department of Neurology (N.S., K.R., P.S., M.H., F.P.), Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany
| | - Joel M Guthridge
- From the Arthritis and Clinical Immunology Research Program (S.G., G.K., R.M.K., K.M., J.M.G., Y.M.-D., G.P., R.C.A.), Oklahoma Medical Research Foundation; Department of Microbiology and Immunology (S.G., R.C.A.), Oklahoma University Health Science Center; NeuroCure Clinical Research Center and Experimental and Clinical Research Center (N.S., K.R., P.S., M.H., F.P.), Max Delbrueck Center for Molecular Medicine and Charité Universitätsmedizin Berlin; and Department of Neurology (N.S., K.R., P.S., M.H., F.P.), Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany
| | - Yang Mao-Draayer
- From the Arthritis and Clinical Immunology Research Program (S.G., G.K., R.M.K., K.M., J.M.G., Y.M.-D., G.P., R.C.A.), Oklahoma Medical Research Foundation; Department of Microbiology and Immunology (S.G., R.C.A.), Oklahoma University Health Science Center; NeuroCure Clinical Research Center and Experimental and Clinical Research Center (N.S., K.R., P.S., M.H., F.P.), Max Delbrueck Center for Molecular Medicine and Charité Universitätsmedizin Berlin; and Department of Neurology (N.S., K.R., P.S., M.H., F.P.), Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany
| | - Patrick Schindler
- From the Arthritis and Clinical Immunology Research Program (S.G., G.K., R.M.K., K.M., J.M.G., Y.M.-D., G.P., R.C.A.), Oklahoma Medical Research Foundation; Department of Microbiology and Immunology (S.G., R.C.A.), Oklahoma University Health Science Center; NeuroCure Clinical Research Center and Experimental and Clinical Research Center (N.S., K.R., P.S., M.H., F.P.), Max Delbrueck Center for Molecular Medicine and Charité Universitätsmedizin Berlin; and Department of Neurology (N.S., K.R., P.S., M.H., F.P.), Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany
| | - Maria Hastermann
- From the Arthritis and Clinical Immunology Research Program (S.G., G.K., R.M.K., K.M., J.M.G., Y.M.-D., G.P., R.C.A.), Oklahoma Medical Research Foundation; Department of Microbiology and Immunology (S.G., R.C.A.), Oklahoma University Health Science Center; NeuroCure Clinical Research Center and Experimental and Clinical Research Center (N.S., K.R., P.S., M.H., F.P.), Max Delbrueck Center for Molecular Medicine and Charité Universitätsmedizin Berlin; and Department of Neurology (N.S., K.R., P.S., M.H., F.P.), Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany
| | - Gabriel Pardo
- From the Arthritis and Clinical Immunology Research Program (S.G., G.K., R.M.K., K.M., J.M.G., Y.M.-D., G.P., R.C.A.), Oklahoma Medical Research Foundation; Department of Microbiology and Immunology (S.G., R.C.A.), Oklahoma University Health Science Center; NeuroCure Clinical Research Center and Experimental and Clinical Research Center (N.S., K.R., P.S., M.H., F.P.), Max Delbrueck Center for Molecular Medicine and Charité Universitätsmedizin Berlin; and Department of Neurology (N.S., K.R., P.S., M.H., F.P.), Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany
| | - Friedemann Paul
- From the Arthritis and Clinical Immunology Research Program (S.G., G.K., R.M.K., K.M., J.M.G., Y.M.-D., G.P., R.C.A.), Oklahoma Medical Research Foundation; Department of Microbiology and Immunology (S.G., R.C.A.), Oklahoma University Health Science Center; NeuroCure Clinical Research Center and Experimental and Clinical Research Center (N.S., K.R., P.S., M.H., F.P.), Max Delbrueck Center for Molecular Medicine and Charité Universitätsmedizin Berlin; and Department of Neurology (N.S., K.R., P.S., M.H., F.P.), Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany
| | - Robert C Axtell
- From the Arthritis and Clinical Immunology Research Program (S.G., G.K., R.M.K., K.M., J.M.G., Y.M.-D., G.P., R.C.A.), Oklahoma Medical Research Foundation; Department of Microbiology and Immunology (S.G., R.C.A.), Oklahoma University Health Science Center; NeuroCure Clinical Research Center and Experimental and Clinical Research Center (N.S., K.R., P.S., M.H., F.P.), Max Delbrueck Center for Molecular Medicine and Charité Universitätsmedizin Berlin; and Department of Neurology (N.S., K.R., P.S., M.H., F.P.), Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany
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Borrelli S, Martire MS, Stölting A, Vanden Bulcke C, Pedrini E, Guisset F, Bugli C, Yildiz H, Pothen L, Elands S, Martinelli V, Smith B, Jacobson S, Du Pasquier RA, Van Pesch V, Filippi M, Reich DS, Absinta M, Maggi P. Central Vein Sign, Cortical Lesions, and Paramagnetic Rim Lesions for the Diagnostic and Prognostic Workup of Multiple Sclerosis. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2024; 11:e200253. [PMID: 38788180 PMCID: PMC11129678 DOI: 10.1212/nxi.0000000000200253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/13/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND AND OBJECTIVES The diagnosis of multiple sclerosis (MS) can be challenging in clinical practice because MS presentation can be atypical and mimicked by other diseases. We evaluated the diagnostic performance, alone or in combination, of the central vein sign (CVS), paramagnetic rim lesion (PRL), and cortical lesion (CL), as well as their association with clinical outcomes. METHODS In this multicenter observational study, we first conducted a cross-sectional analysis of the CVS (proportion of CVS-positive lesions or simplified determination of CVS in 3/6 lesions-Select3*/Select6*), PRL, and CL in MS and non-MS cases on 3T-MRI brain images, including 3D T2-FLAIR, T2*-echo-planar imaging magnitude and phase, double inversion recovery, and magnetization prepared rapid gradient echo image sequences. Then, we longitudinally analyzed the progression independent of relapse and MRI activity (PIRA) in MS cases over the 2 years after study entry. Receiver operating characteristic curves were used to test diagnostic performance and regression models to predict diagnosis and clinical outcomes. RESULTS The presence of ≥41% CVS-positive lesions/≥1 CL/≥1 PRL (optimal cutoffs) had 96%/90%/93% specificity, 97%/84%/60% sensitivity, and 0.99/0.90/0.77 area under the curve (AUC), respectively, to distinguish MS (n = 185) from non-MS (n = 100) cases. The Select3*/Select6* algorithms showed 93%/95% specificity, 97%/89% sensitivity, and 0.95/0.92 AUC. The combination of CVS, CL, and PRL improved the diagnostic performance, especially when Select3*/Select6* were used (93%/94% specificity, 98%/96% sensitivity, 0.99/0.98 AUC; p = 0.002/p < 0.001). In MS cases (n = 185), both CL and PRL were associated with higher MS disability and severity. Longitudinal analysis (n = 61) showed that MS cases with >4 PRL at baseline were more likely to experience PIRA at 2-year follow-up (odds ratio 17.0, 95% confidence interval: 2.1-138.5; p = 0.008), whereas no association was observed between other baseline MRI measures and PIRA, including the number of CL. DISCUSSION The combination of CVS, CL, and PRL can improve MS differential diagnosis. CL and PRL also correlated with clinical measures of poor prognosis, with PRL being a predictor of disability accrual independent of clinical/MRI activity.
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Affiliation(s)
- Serena Borrelli
- From the Neuroinflammation Imaging Lab (NIL) (S.B., A.S., C.V.B., F.G., P.M.), Institute of NeuroScience, Université catholique de Louvain; Department of Neurology (S.B., S.E.), Hôpital Erasme, Hôpital Universitaire de Bruxelles; Department of Neurology (S.B.), Centre Hospitalier Universitaire Brugmann, Université Libre de Brussels, Belgium; Neurology Unit (M.S.M., V.M., M.F.), IRCCS San Raffaele Hospital, Milan, Italy; ICTEAM Institute (C.V.B.), Université catholique de Louvain, Louvain-la-Neuve, Belgium; Vita-Salute San Raffaele University (E.P., M.F., M.A.); Translational Neuropathology Unit (E.P., M.A.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Plateforme technologique de Support en Méthodologie et Calcul Statistique (C.B.); Department of Internal Medicine and Infectious Diseases (H.Y., L.P.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Section of Infections of the Nervous System (B.S.); Viral Immunology Section (S.J.), National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD; Neurology Service (R.A.D.P., P.M.), Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland; Department of Neurology (V.V.P., P.M.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Neuroimaging Research Unit (M.F.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Translational Neuroradiology Section (D.S.R.), National Institute of Neurological Disorders and Stroke (NINDS), National In-stitutes of Health (NIH); and Department of Neurology (M.A.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Maria Sofia Martire
- From the Neuroinflammation Imaging Lab (NIL) (S.B., A.S., C.V.B., F.G., P.M.), Institute of NeuroScience, Université catholique de Louvain; Department of Neurology (S.B., S.E.), Hôpital Erasme, Hôpital Universitaire de Bruxelles; Department of Neurology (S.B.), Centre Hospitalier Universitaire Brugmann, Université Libre de Brussels, Belgium; Neurology Unit (M.S.M., V.M., M.F.), IRCCS San Raffaele Hospital, Milan, Italy; ICTEAM Institute (C.V.B.), Université catholique de Louvain, Louvain-la-Neuve, Belgium; Vita-Salute San Raffaele University (E.P., M.F., M.A.); Translational Neuropathology Unit (E.P., M.A.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Plateforme technologique de Support en Méthodologie et Calcul Statistique (C.B.); Department of Internal Medicine and Infectious Diseases (H.Y., L.P.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Section of Infections of the Nervous System (B.S.); Viral Immunology Section (S.J.), National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD; Neurology Service (R.A.D.P., P.M.), Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland; Department of Neurology (V.V.P., P.M.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Neuroimaging Research Unit (M.F.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Translational Neuroradiology Section (D.S.R.), National Institute of Neurological Disorders and Stroke (NINDS), National In-stitutes of Health (NIH); and Department of Neurology (M.A.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Anna Stölting
- From the Neuroinflammation Imaging Lab (NIL) (S.B., A.S., C.V.B., F.G., P.M.), Institute of NeuroScience, Université catholique de Louvain; Department of Neurology (S.B., S.E.), Hôpital Erasme, Hôpital Universitaire de Bruxelles; Department of Neurology (S.B.), Centre Hospitalier Universitaire Brugmann, Université Libre de Brussels, Belgium; Neurology Unit (M.S.M., V.M., M.F.), IRCCS San Raffaele Hospital, Milan, Italy; ICTEAM Institute (C.V.B.), Université catholique de Louvain, Louvain-la-Neuve, Belgium; Vita-Salute San Raffaele University (E.P., M.F., M.A.); Translational Neuropathology Unit (E.P., M.A.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Plateforme technologique de Support en Méthodologie et Calcul Statistique (C.B.); Department of Internal Medicine and Infectious Diseases (H.Y., L.P.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Section of Infections of the Nervous System (B.S.); Viral Immunology Section (S.J.), National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD; Neurology Service (R.A.D.P., P.M.), Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland; Department of Neurology (V.V.P., P.M.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Neuroimaging Research Unit (M.F.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Translational Neuroradiology Section (D.S.R.), National Institute of Neurological Disorders and Stroke (NINDS), National In-stitutes of Health (NIH); and Department of Neurology (M.A.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Colin Vanden Bulcke
- From the Neuroinflammation Imaging Lab (NIL) (S.B., A.S., C.V.B., F.G., P.M.), Institute of NeuroScience, Université catholique de Louvain; Department of Neurology (S.B., S.E.), Hôpital Erasme, Hôpital Universitaire de Bruxelles; Department of Neurology (S.B.), Centre Hospitalier Universitaire Brugmann, Université Libre de Brussels, Belgium; Neurology Unit (M.S.M., V.M., M.F.), IRCCS San Raffaele Hospital, Milan, Italy; ICTEAM Institute (C.V.B.), Université catholique de Louvain, Louvain-la-Neuve, Belgium; Vita-Salute San Raffaele University (E.P., M.F., M.A.); Translational Neuropathology Unit (E.P., M.A.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Plateforme technologique de Support en Méthodologie et Calcul Statistique (C.B.); Department of Internal Medicine and Infectious Diseases (H.Y., L.P.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Section of Infections of the Nervous System (B.S.); Viral Immunology Section (S.J.), National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD; Neurology Service (R.A.D.P., P.M.), Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland; Department of Neurology (V.V.P., P.M.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Neuroimaging Research Unit (M.F.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Translational Neuroradiology Section (D.S.R.), National Institute of Neurological Disorders and Stroke (NINDS), National In-stitutes of Health (NIH); and Department of Neurology (M.A.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Edoardo Pedrini
- From the Neuroinflammation Imaging Lab (NIL) (S.B., A.S., C.V.B., F.G., P.M.), Institute of NeuroScience, Université catholique de Louvain; Department of Neurology (S.B., S.E.), Hôpital Erasme, Hôpital Universitaire de Bruxelles; Department of Neurology (S.B.), Centre Hospitalier Universitaire Brugmann, Université Libre de Brussels, Belgium; Neurology Unit (M.S.M., V.M., M.F.), IRCCS San Raffaele Hospital, Milan, Italy; ICTEAM Institute (C.V.B.), Université catholique de Louvain, Louvain-la-Neuve, Belgium; Vita-Salute San Raffaele University (E.P., M.F., M.A.); Translational Neuropathology Unit (E.P., M.A.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Plateforme technologique de Support en Méthodologie et Calcul Statistique (C.B.); Department of Internal Medicine and Infectious Diseases (H.Y., L.P.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Section of Infections of the Nervous System (B.S.); Viral Immunology Section (S.J.), National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD; Neurology Service (R.A.D.P., P.M.), Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland; Department of Neurology (V.V.P., P.M.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Neuroimaging Research Unit (M.F.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Translational Neuroradiology Section (D.S.R.), National Institute of Neurological Disorders and Stroke (NINDS), National In-stitutes of Health (NIH); and Department of Neurology (M.A.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - François Guisset
- From the Neuroinflammation Imaging Lab (NIL) (S.B., A.S., C.V.B., F.G., P.M.), Institute of NeuroScience, Université catholique de Louvain; Department of Neurology (S.B., S.E.), Hôpital Erasme, Hôpital Universitaire de Bruxelles; Department of Neurology (S.B.), Centre Hospitalier Universitaire Brugmann, Université Libre de Brussels, Belgium; Neurology Unit (M.S.M., V.M., M.F.), IRCCS San Raffaele Hospital, Milan, Italy; ICTEAM Institute (C.V.B.), Université catholique de Louvain, Louvain-la-Neuve, Belgium; Vita-Salute San Raffaele University (E.P., M.F., M.A.); Translational Neuropathology Unit (E.P., M.A.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Plateforme technologique de Support en Méthodologie et Calcul Statistique (C.B.); Department of Internal Medicine and Infectious Diseases (H.Y., L.P.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Section of Infections of the Nervous System (B.S.); Viral Immunology Section (S.J.), National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD; Neurology Service (R.A.D.P., P.M.), Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland; Department of Neurology (V.V.P., P.M.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Neuroimaging Research Unit (M.F.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Translational Neuroradiology Section (D.S.R.), National Institute of Neurological Disorders and Stroke (NINDS), National In-stitutes of Health (NIH); and Department of Neurology (M.A.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Céline Bugli
- From the Neuroinflammation Imaging Lab (NIL) (S.B., A.S., C.V.B., F.G., P.M.), Institute of NeuroScience, Université catholique de Louvain; Department of Neurology (S.B., S.E.), Hôpital Erasme, Hôpital Universitaire de Bruxelles; Department of Neurology (S.B.), Centre Hospitalier Universitaire Brugmann, Université Libre de Brussels, Belgium; Neurology Unit (M.S.M., V.M., M.F.), IRCCS San Raffaele Hospital, Milan, Italy; ICTEAM Institute (C.V.B.), Université catholique de Louvain, Louvain-la-Neuve, Belgium; Vita-Salute San Raffaele University (E.P., M.F., M.A.); Translational Neuropathology Unit (E.P., M.A.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Plateforme technologique de Support en Méthodologie et Calcul Statistique (C.B.); Department of Internal Medicine and Infectious Diseases (H.Y., L.P.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Section of Infections of the Nervous System (B.S.); Viral Immunology Section (S.J.), National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD; Neurology Service (R.A.D.P., P.M.), Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland; Department of Neurology (V.V.P., P.M.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Neuroimaging Research Unit (M.F.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Translational Neuroradiology Section (D.S.R.), National Institute of Neurological Disorders and Stroke (NINDS), National In-stitutes of Health (NIH); and Department of Neurology (M.A.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Halil Yildiz
- From the Neuroinflammation Imaging Lab (NIL) (S.B., A.S., C.V.B., F.G., P.M.), Institute of NeuroScience, Université catholique de Louvain; Department of Neurology (S.B., S.E.), Hôpital Erasme, Hôpital Universitaire de Bruxelles; Department of Neurology (S.B.), Centre Hospitalier Universitaire Brugmann, Université Libre de Brussels, Belgium; Neurology Unit (M.S.M., V.M., M.F.), IRCCS San Raffaele Hospital, Milan, Italy; ICTEAM Institute (C.V.B.), Université catholique de Louvain, Louvain-la-Neuve, Belgium; Vita-Salute San Raffaele University (E.P., M.F., M.A.); Translational Neuropathology Unit (E.P., M.A.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Plateforme technologique de Support en Méthodologie et Calcul Statistique (C.B.); Department of Internal Medicine and Infectious Diseases (H.Y., L.P.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Section of Infections of the Nervous System (B.S.); Viral Immunology Section (S.J.), National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD; Neurology Service (R.A.D.P., P.M.), Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland; Department of Neurology (V.V.P., P.M.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Neuroimaging Research Unit (M.F.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Translational Neuroradiology Section (D.S.R.), National Institute of Neurological Disorders and Stroke (NINDS), National In-stitutes of Health (NIH); and Department of Neurology (M.A.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Lucie Pothen
- From the Neuroinflammation Imaging Lab (NIL) (S.B., A.S., C.V.B., F.G., P.M.), Institute of NeuroScience, Université catholique de Louvain; Department of Neurology (S.B., S.E.), Hôpital Erasme, Hôpital Universitaire de Bruxelles; Department of Neurology (S.B.), Centre Hospitalier Universitaire Brugmann, Université Libre de Brussels, Belgium; Neurology Unit (M.S.M., V.M., M.F.), IRCCS San Raffaele Hospital, Milan, Italy; ICTEAM Institute (C.V.B.), Université catholique de Louvain, Louvain-la-Neuve, Belgium; Vita-Salute San Raffaele University (E.P., M.F., M.A.); Translational Neuropathology Unit (E.P., M.A.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Plateforme technologique de Support en Méthodologie et Calcul Statistique (C.B.); Department of Internal Medicine and Infectious Diseases (H.Y., L.P.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Section of Infections of the Nervous System (B.S.); Viral Immunology Section (S.J.), National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD; Neurology Service (R.A.D.P., P.M.), Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland; Department of Neurology (V.V.P., P.M.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Neuroimaging Research Unit (M.F.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Translational Neuroradiology Section (D.S.R.), National Institute of Neurological Disorders and Stroke (NINDS), National In-stitutes of Health (NIH); and Department of Neurology (M.A.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Sophie Elands
- From the Neuroinflammation Imaging Lab (NIL) (S.B., A.S., C.V.B., F.G., P.M.), Institute of NeuroScience, Université catholique de Louvain; Department of Neurology (S.B., S.E.), Hôpital Erasme, Hôpital Universitaire de Bruxelles; Department of Neurology (S.B.), Centre Hospitalier Universitaire Brugmann, Université Libre de Brussels, Belgium; Neurology Unit (M.S.M., V.M., M.F.), IRCCS San Raffaele Hospital, Milan, Italy; ICTEAM Institute (C.V.B.), Université catholique de Louvain, Louvain-la-Neuve, Belgium; Vita-Salute San Raffaele University (E.P., M.F., M.A.); Translational Neuropathology Unit (E.P., M.A.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Plateforme technologique de Support en Méthodologie et Calcul Statistique (C.B.); Department of Internal Medicine and Infectious Diseases (H.Y., L.P.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Section of Infections of the Nervous System (B.S.); Viral Immunology Section (S.J.), National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD; Neurology Service (R.A.D.P., P.M.), Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland; Department of Neurology (V.V.P., P.M.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Neuroimaging Research Unit (M.F.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Translational Neuroradiology Section (D.S.R.), National Institute of Neurological Disorders and Stroke (NINDS), National In-stitutes of Health (NIH); and Department of Neurology (M.A.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Vittorio Martinelli
- From the Neuroinflammation Imaging Lab (NIL) (S.B., A.S., C.V.B., F.G., P.M.), Institute of NeuroScience, Université catholique de Louvain; Department of Neurology (S.B., S.E.), Hôpital Erasme, Hôpital Universitaire de Bruxelles; Department of Neurology (S.B.), Centre Hospitalier Universitaire Brugmann, Université Libre de Brussels, Belgium; Neurology Unit (M.S.M., V.M., M.F.), IRCCS San Raffaele Hospital, Milan, Italy; ICTEAM Institute (C.V.B.), Université catholique de Louvain, Louvain-la-Neuve, Belgium; Vita-Salute San Raffaele University (E.P., M.F., M.A.); Translational Neuropathology Unit (E.P., M.A.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Plateforme technologique de Support en Méthodologie et Calcul Statistique (C.B.); Department of Internal Medicine and Infectious Diseases (H.Y., L.P.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Section of Infections of the Nervous System (B.S.); Viral Immunology Section (S.J.), National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD; Neurology Service (R.A.D.P., P.M.), Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland; Department of Neurology (V.V.P., P.M.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Neuroimaging Research Unit (M.F.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Translational Neuroradiology Section (D.S.R.), National Institute of Neurological Disorders and Stroke (NINDS), National In-stitutes of Health (NIH); and Department of Neurology (M.A.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Bryan Smith
- From the Neuroinflammation Imaging Lab (NIL) (S.B., A.S., C.V.B., F.G., P.M.), Institute of NeuroScience, Université catholique de Louvain; Department of Neurology (S.B., S.E.), Hôpital Erasme, Hôpital Universitaire de Bruxelles; Department of Neurology (S.B.), Centre Hospitalier Universitaire Brugmann, Université Libre de Brussels, Belgium; Neurology Unit (M.S.M., V.M., M.F.), IRCCS San Raffaele Hospital, Milan, Italy; ICTEAM Institute (C.V.B.), Université catholique de Louvain, Louvain-la-Neuve, Belgium; Vita-Salute San Raffaele University (E.P., M.F., M.A.); Translational Neuropathology Unit (E.P., M.A.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Plateforme technologique de Support en Méthodologie et Calcul Statistique (C.B.); Department of Internal Medicine and Infectious Diseases (H.Y., L.P.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Section of Infections of the Nervous System (B.S.); Viral Immunology Section (S.J.), National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD; Neurology Service (R.A.D.P., P.M.), Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland; Department of Neurology (V.V.P., P.M.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Neuroimaging Research Unit (M.F.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Translational Neuroradiology Section (D.S.R.), National Institute of Neurological Disorders and Stroke (NINDS), National In-stitutes of Health (NIH); and Department of Neurology (M.A.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Steven Jacobson
- From the Neuroinflammation Imaging Lab (NIL) (S.B., A.S., C.V.B., F.G., P.M.), Institute of NeuroScience, Université catholique de Louvain; Department of Neurology (S.B., S.E.), Hôpital Erasme, Hôpital Universitaire de Bruxelles; Department of Neurology (S.B.), Centre Hospitalier Universitaire Brugmann, Université Libre de Brussels, Belgium; Neurology Unit (M.S.M., V.M., M.F.), IRCCS San Raffaele Hospital, Milan, Italy; ICTEAM Institute (C.V.B.), Université catholique de Louvain, Louvain-la-Neuve, Belgium; Vita-Salute San Raffaele University (E.P., M.F., M.A.); Translational Neuropathology Unit (E.P., M.A.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Plateforme technologique de Support en Méthodologie et Calcul Statistique (C.B.); Department of Internal Medicine and Infectious Diseases (H.Y., L.P.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Section of Infections of the Nervous System (B.S.); Viral Immunology Section (S.J.), National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD; Neurology Service (R.A.D.P., P.M.), Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland; Department of Neurology (V.V.P., P.M.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Neuroimaging Research Unit (M.F.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Translational Neuroradiology Section (D.S.R.), National Institute of Neurological Disorders and Stroke (NINDS), National In-stitutes of Health (NIH); and Department of Neurology (M.A.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Renaud A Du Pasquier
- From the Neuroinflammation Imaging Lab (NIL) (S.B., A.S., C.V.B., F.G., P.M.), Institute of NeuroScience, Université catholique de Louvain; Department of Neurology (S.B., S.E.), Hôpital Erasme, Hôpital Universitaire de Bruxelles; Department of Neurology (S.B.), Centre Hospitalier Universitaire Brugmann, Université Libre de Brussels, Belgium; Neurology Unit (M.S.M., V.M., M.F.), IRCCS San Raffaele Hospital, Milan, Italy; ICTEAM Institute (C.V.B.), Université catholique de Louvain, Louvain-la-Neuve, Belgium; Vita-Salute San Raffaele University (E.P., M.F., M.A.); Translational Neuropathology Unit (E.P., M.A.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Plateforme technologique de Support en Méthodologie et Calcul Statistique (C.B.); Department of Internal Medicine and Infectious Diseases (H.Y., L.P.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Section of Infections of the Nervous System (B.S.); Viral Immunology Section (S.J.), National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD; Neurology Service (R.A.D.P., P.M.), Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland; Department of Neurology (V.V.P., P.M.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Neuroimaging Research Unit (M.F.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Translational Neuroradiology Section (D.S.R.), National Institute of Neurological Disorders and Stroke (NINDS), National In-stitutes of Health (NIH); and Department of Neurology (M.A.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Vincent Van Pesch
- From the Neuroinflammation Imaging Lab (NIL) (S.B., A.S., C.V.B., F.G., P.M.), Institute of NeuroScience, Université catholique de Louvain; Department of Neurology (S.B., S.E.), Hôpital Erasme, Hôpital Universitaire de Bruxelles; Department of Neurology (S.B.), Centre Hospitalier Universitaire Brugmann, Université Libre de Brussels, Belgium; Neurology Unit (M.S.M., V.M., M.F.), IRCCS San Raffaele Hospital, Milan, Italy; ICTEAM Institute (C.V.B.), Université catholique de Louvain, Louvain-la-Neuve, Belgium; Vita-Salute San Raffaele University (E.P., M.F., M.A.); Translational Neuropathology Unit (E.P., M.A.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Plateforme technologique de Support en Méthodologie et Calcul Statistique (C.B.); Department of Internal Medicine and Infectious Diseases (H.Y., L.P.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Section of Infections of the Nervous System (B.S.); Viral Immunology Section (S.J.), National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD; Neurology Service (R.A.D.P., P.M.), Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland; Department of Neurology (V.V.P., P.M.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Neuroimaging Research Unit (M.F.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Translational Neuroradiology Section (D.S.R.), National Institute of Neurological Disorders and Stroke (NINDS), National In-stitutes of Health (NIH); and Department of Neurology (M.A.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Massimo Filippi
- From the Neuroinflammation Imaging Lab (NIL) (S.B., A.S., C.V.B., F.G., P.M.), Institute of NeuroScience, Université catholique de Louvain; Department of Neurology (S.B., S.E.), Hôpital Erasme, Hôpital Universitaire de Bruxelles; Department of Neurology (S.B.), Centre Hospitalier Universitaire Brugmann, Université Libre de Brussels, Belgium; Neurology Unit (M.S.M., V.M., M.F.), IRCCS San Raffaele Hospital, Milan, Italy; ICTEAM Institute (C.V.B.), Université catholique de Louvain, Louvain-la-Neuve, Belgium; Vita-Salute San Raffaele University (E.P., M.F., M.A.); Translational Neuropathology Unit (E.P., M.A.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Plateforme technologique de Support en Méthodologie et Calcul Statistique (C.B.); Department of Internal Medicine and Infectious Diseases (H.Y., L.P.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Section of Infections of the Nervous System (B.S.); Viral Immunology Section (S.J.), National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD; Neurology Service (R.A.D.P., P.M.), Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland; Department of Neurology (V.V.P., P.M.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Neuroimaging Research Unit (M.F.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Translational Neuroradiology Section (D.S.R.), National Institute of Neurological Disorders and Stroke (NINDS), National In-stitutes of Health (NIH); and Department of Neurology (M.A.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Daniel S Reich
- From the Neuroinflammation Imaging Lab (NIL) (S.B., A.S., C.V.B., F.G., P.M.), Institute of NeuroScience, Université catholique de Louvain; Department of Neurology (S.B., S.E.), Hôpital Erasme, Hôpital Universitaire de Bruxelles; Department of Neurology (S.B.), Centre Hospitalier Universitaire Brugmann, Université Libre de Brussels, Belgium; Neurology Unit (M.S.M., V.M., M.F.), IRCCS San Raffaele Hospital, Milan, Italy; ICTEAM Institute (C.V.B.), Université catholique de Louvain, Louvain-la-Neuve, Belgium; Vita-Salute San Raffaele University (E.P., M.F., M.A.); Translational Neuropathology Unit (E.P., M.A.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Plateforme technologique de Support en Méthodologie et Calcul Statistique (C.B.); Department of Internal Medicine and Infectious Diseases (H.Y., L.P.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Section of Infections of the Nervous System (B.S.); Viral Immunology Section (S.J.), National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD; Neurology Service (R.A.D.P., P.M.), Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland; Department of Neurology (V.V.P., P.M.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Neuroimaging Research Unit (M.F.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Translational Neuroradiology Section (D.S.R.), National Institute of Neurological Disorders and Stroke (NINDS), National In-stitutes of Health (NIH); and Department of Neurology (M.A.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Martina Absinta
- From the Neuroinflammation Imaging Lab (NIL) (S.B., A.S., C.V.B., F.G., P.M.), Institute of NeuroScience, Université catholique de Louvain; Department of Neurology (S.B., S.E.), Hôpital Erasme, Hôpital Universitaire de Bruxelles; Department of Neurology (S.B.), Centre Hospitalier Universitaire Brugmann, Université Libre de Brussels, Belgium; Neurology Unit (M.S.M., V.M., M.F.), IRCCS San Raffaele Hospital, Milan, Italy; ICTEAM Institute (C.V.B.), Université catholique de Louvain, Louvain-la-Neuve, Belgium; Vita-Salute San Raffaele University (E.P., M.F., M.A.); Translational Neuropathology Unit (E.P., M.A.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Plateforme technologique de Support en Méthodologie et Calcul Statistique (C.B.); Department of Internal Medicine and Infectious Diseases (H.Y., L.P.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Section of Infections of the Nervous System (B.S.); Viral Immunology Section (S.J.), National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD; Neurology Service (R.A.D.P., P.M.), Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland; Department of Neurology (V.V.P., P.M.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Neuroimaging Research Unit (M.F.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Translational Neuroradiology Section (D.S.R.), National Institute of Neurological Disorders and Stroke (NINDS), National In-stitutes of Health (NIH); and Department of Neurology (M.A.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Pietro Maggi
- From the Neuroinflammation Imaging Lab (NIL) (S.B., A.S., C.V.B., F.G., P.M.), Institute of NeuroScience, Université catholique de Louvain; Department of Neurology (S.B., S.E.), Hôpital Erasme, Hôpital Universitaire de Bruxelles; Department of Neurology (S.B.), Centre Hospitalier Universitaire Brugmann, Université Libre de Brussels, Belgium; Neurology Unit (M.S.M., V.M., M.F.), IRCCS San Raffaele Hospital, Milan, Italy; ICTEAM Institute (C.V.B.), Université catholique de Louvain, Louvain-la-Neuve, Belgium; Vita-Salute San Raffaele University (E.P., M.F., M.A.); Translational Neuropathology Unit (E.P., M.A.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Plateforme technologique de Support en Méthodologie et Calcul Statistique (C.B.); Department of Internal Medicine and Infectious Diseases (H.Y., L.P.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Section of Infections of the Nervous System (B.S.); Viral Immunology Section (S.J.), National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD; Neurology Service (R.A.D.P., P.M.), Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Switzerland; Department of Neurology (V.V.P., P.M.), Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium; Neuroimaging Research Unit (M.F.), Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Translational Neuroradiology Section (D.S.R.), National Institute of Neurological Disorders and Stroke (NINDS), National In-stitutes of Health (NIH); and Department of Neurology (M.A.), Johns Hopkins University School of Medicine, Baltimore, MD
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The Indian multiple sclerosis and allied demyelinating disorders registry and research network (IMSRN): Inception to reality. Mult Scler Relat Disord 2024; 87:105627. [PMID: 38704875 DOI: 10.1016/j.msard.2024.105627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 04/07/2024] [Accepted: 04/13/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Demyelinating disorders of the CNS are a set of chronic, inflammatory, autoimmune conditions. To improve understanding of epidemiology, population characteristics and disease behaviour, an Indian, hospital-based registry has been established to serve as a platform for fostering collaborative research. The following article outlines the development, governance and current status of the Indian Multiple Sclerosis and Allied Demyelinating Disorders Registry and Research Network (IMSRN), the country's first scientific database and dedicated expert research network of these disorders. METHODS Multiple reviews and stakeholder meetings were held to set up the registry. The IMSRN was formally initiated in August 2021 across 26 tertiary care centres. The registry is governed by the Indian Council of Medical Research (ICMR), New Delhi and its task force committee. The online secure database captures detailed clinical and imaging patient details at baseline and periodic follow up. Periodic meetings of the task force and collaborators are held to discuss the progress, improvements and research proposals. RESULTS The IMSRN is currently active and recruiting patients following an informed consent. As of current, more than 3336 patients including RIS (N = 8), CIS (N = 134), MS (N = 1674), NMOSD (N= 561), MOGAD (N = 404), ADEM (N = 46), CRION (N = 21), CLIPPERS (N = 2), and GFAP (N =1) have been enrolled. 340 patients, not meeting the diagnostic criteria for any of the aforementioned disease phenotypes are in the others category. Various research proposals are being developed to study different aspects of these disorders. CONCLUSION The IMSRN has been established with a vision to strengthen our understanding about MS, NMOSD, MOGAD, and other demyelinating disorders. This would help answer important questions related to disease profiles and long-term outcomes of patients in the Indian setting. From the standpoint of clinical practice, therapeutics, patient management, research, and national policy building, IMSRN shall serve as a synergising platform for bridging the gap in the aforementioned areas and guiding future research through national and international collaboration.
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Neuteboom RF. Testing for MOG-IgG in CSF: Relevant or not? Eur J Paediatr Neurol 2024; 51:A1. [PMID: 38987069 DOI: 10.1016/j.ejpn.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Affiliation(s)
- R F Neuteboom
- Department of Neurology, Erasmus MC, Sophia Children's Hospital, the Netherlands.
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Cui Y, Wu B, Wu J, Zhang S, Guo P, Shu J, Li D, Cai C. Novel Genetic Variants Distinguishing Myelin Oligodendrocyte Glycoprotein-IgG-Positive From Myelin Oligodendrocyte Glycoprotein-IgG-Negative Pediatric Acute Disseminated Encephalomyelitis in Northern China. Pediatr Neurol 2024; 156:155-161. [PMID: 38781724 DOI: 10.1016/j.pediatrneurol.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 04/01/2024] [Accepted: 04/12/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Acute disseminated encephalomyelitis (ADEM) is a common phenotype in children with myelin oligodendrocyte glycoprotein IgG (MOG-IgG)-associated disease. We aimed to identify novel genetic variants that distinguish children with MOG-IgG-positive ADEM (MOG-IgG+ ADEM) from children with MOG-IgG-negative ADEM (MOG-IgG- ADEM) using whole exome sequencing (WES) analysis. METHODS We conducted a two-stage study design. First, we performed WES on five patients with MOG-IgG+ ADEM and five patients with MOG-IgG- ADEM. Following bioinformatics analysis, the candidate variant list was constructed. Second, 29 children with MOG-IgG+ ADEM and 27 children with MOG-IgG- ADEM, together with discovery cohort, were genotyped to identify the novel variants. RESULTS WES resulted in 33,999 variants, and 5388 nonsynonymous variants were selected for downstream analysis. In total, 118 protein-affecting variants that were significantly different between the two groups were identified. Together with the five variants extracted from the literature, 49 variants were selected as the candidate variant list for genotyping in the replication cohort. Finally, we identified three variants: rs11171951 in NACα, rs231775 in CTLA4, and rs11171951 in GOLGA5, which were significantly different between MOG-IgG+ ADEM and MOG-IgG- ADEM. Only rs12440118 in NACα remained significant after Bonferroni correction for multiple testing (Padj < 0.001). CONCLUSIONS We identified strong associations between NACα, CTLA4, and GOLGA5 variants and MOG-IgG+ ADEM in a Han Chinese population of Northern China, which may present novel genetic risk factor distinguishing patients with MOG-IgG+ ADEM from those with MOG-IgG- ADEM.
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Affiliation(s)
- Yaqiong Cui
- Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China
| | - Bo Wu
- Department of Neurology, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China
| | - Jinying Wu
- Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China
| | - Shuyue Zhang
- Basic Medical College, Tianjin Medical University, Tianjin, China
| | - Pan Guo
- Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China
| | - Jianbo Shu
- Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China.
| | - Dong Li
- Department of Neurology, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China.
| | - Chunquan Cai
- Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin Pediatric Research Institute, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, China.
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