RT Journal Article
SR Electronic
T1 Impaired Brain Growth in Myelin Oligodendrocyte Glycoprotein Antibody–Associated Acute Disseminated Encephalomyelitis
JF Neurology - Neuroimmunology Neuroinflammation
JO Neurol Neuroimmunol Neuroinflamm
FD Lippincott Williams & Wilkins
SP e200066
DO 10.1212/NXI.0000000000200066
VO 10
IS 2
A1 Frederik Bartels
A1 Birgit Baumgartner
A1 Annette Aigner
A1 Graham Cooper
A1 Astrid Blaschek
A1 Eva Maria Wendel
A1 Annikki Bertolini
A1 Michael Karenfort
A1 Matthias Baumann
A1 Robert Cleaveland
A1 Andreas Wegener-Panzer
A1 Steffen Leiz
A1 Michela Salandin
A1 Peter Krieg
A1 Tobias Reindl
A1 Markus Reindl
A1 Carsten Finke
A1 Kevin Rostásy
YR 2023
UL http://nn.neurology.org/content/10/2/e200066.abstract
AB Background and Objectives Acute disseminated encephalomyelitis (ADEM) is the most common phenotype in pediatric myelin oligodendrocyte glycoprotein (MOG) antibody–associated disease. A previous study demonstrated impaired brain growth in ADEM. However, the effect of MOG antibodies on brain growth remains unknown. Here, we performed brain volume analyses in MOG-positive and MOG-negative ADEM at onset and over time.Methods In this observational cohort study, we included a total of 62 MRI scans from 24 patients with ADEM (54.2% female; median age 5 years), of which 16 (66.7%) were MOG positive. Patients were compared with healthy controls from the NIH pediatric MRI data repository and a matched local cohort. Mixed-effect models were applied to assess group differences and other relevant factors, including relapses.Results At baseline and before any steroid treatment, patients with ADEM, irrespective of MOG antibody status, showed reduced brain volume compared with matched controls (median [interquartile range] 1,741.9 cm3 [1,645.1–1,805.2] vs 1,810.4 cm3 [1,786.5–1,836.2]). Longitudinal analysis revealed reduced brain growth for both MOG-positive and MOG-negative patients with ADEM. However, MOG-negative patients showed a stronger reduction (−138.3 cm3 [95% CI −193.6 to −82.9]) than MOG-positive patients (−50.0 cm3 [−126.5 to −5.2]), independent of age, sex, and treatment. Relapsing patients (all MOG positive) showed additional brain volume loss (−15.8 cm3 [−68.9 to 37.3]).Discussion Patients with ADEM exhibit brain volume loss and failure of age-expected brain growth. Importantly, MOG-negative status was associated with a more pronounced brain volume loss compared with MOG-positive patients.3D=three dimensional; ADEM=acute disseminated encephalomyelitis; ADS=acquired demyelinating syndrome; EDSS=Expanded Disability Status Scale; GM=gray matter; IVIG=IV immunoglobulin; MDEM=multiphasic ADEM; MOG=myelin oligodendrocyte glycoprotein; MOGAD=MOG antibody–associated disease; MS=multiple sclerosis; NfL=neurofilament light chain; OND=other neurologic disorders; POMS=pediatric-onset MS; WBV=whole-brain volume; WM=white matter