Impaired Brain Growth in Myelin Oligodendrocyte Glycoprotein Antibody-Associated Acute Disseminated Encephalomyelitis.

Abstract

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.

• Authors: Frederik Bartels, Birgit Baumgartner, Annette Aigner, Graham Cooper, Astrid Blaschek, Eva Maria Wendel, Annikki Bertolini, Michael Karenfort, Matthias Baumann, Robert Cleaveland, Andreas Wegener-Panzer, Steffen Leiz, Michela Salandin, Peter Krieg, Tobias Reindl, Markus Reindl, Carsten Finke, Kevin Rostásy
• Journal: Neurology(R) neuroimmunology & neuroinflammation (Neurol Neuroimmunol Neuroinflamm) Vol. 10 Issue 2 (03 2023) ISSN: 2332-7812 [Electronic] United States
• PMID: 36754833 (Publication Type: Observational Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

Chemical References

• Autoantibodies
• Myelin-Oligodendrocyte Glycoprotein

Topics

• Female
• Humans
• Male
• Autoantibodies
• Brain (diagnostic imaging)
• Cohort Studies
• Encephalomyelitis, Acute Disseminated (diagnostic imaging)
• Myelin-Oligodendrocyte Glycoprotein
• Child, Preschool