부산대학교 도서관

Objective: Myelin oligodendrocyte glycoprotein antibodies (MOG‐Ab) distinguish multiple sclerosis (MS) from MOG‐associated disease in most cases. However, studies analyzing MOG‐Ab at the time of a first demyelinating event suggestive of MS in adults are lacking. We aimed to (1) evaluate the prevalence of MOG‐Ab in a first demyelinating event suggestive of MS and (2) compare clinical and paraclinical features between seropositive (MOG‐Ab+) and seronegative (MOG‐Ab−) patients. Methods: Six hundred thirty adult patients with available serum samples obtained within 6 months from the first event were included. MOG‐Ab were analyzed using a live cell‐based assay. Statistical analyses included parametric and nonparametric tests, logistic regression, and survival models. Results: MOG‐Ab were positive in 17 of 630 (2.7%). Fourteen out of 17 (82.4%) MOG‐Ab+ patients presented with optic neuritis (ON) compared to 227of 613 (37.0%) MOG‐Ab− patients (p = 0.009). Cerebrospinal fluid‐restricted oligoclonal bands (CSF‐OBs) were found in 2 of 16 (12.5%) MOG‐Ab+ versus 371 of 601 (61.7%) MOG‐Ab− subjects (p < 0.001). Baseline brain magnetic resonance imaging (MRI) was normal in 9 of 17 (52.9%) MOG‐Ab+ versus 153 of 585 (26.2%) MOG‐Ab− patients (p = 0.029). Absence of CSF‐OBs and ON at onset were independently associated with MOG‐Ab positivity (odds ratio [OR] = 9.03, 95% confidence interval [CI] = 2.04–53.6, p = 0.009; and OR = 4.17, 95% CI = 1.15–19.8, p = 0.042, respectively). Of MOG‐Ab+ patients, 22.9% (95% CI = 0.0–42.7) compared to 67.6% (95% CI = 63.3–71.3) of MOG‐Ab− patients fulfilled McDonald 2017 criteria at 5 years (log‐rank p = 0.003). Interpretation: MOG‐Ab are infrequent in adults with a first demyelinating event suggestive of MS. However, based on our results, we suggest to determine these antibodies in those patients with ON and absence of CSF‐OBs, as long as the brain MRI is not suggestive of MS. ANN NEUROL 2024;95:116–128 [ABSTRACT FROM AUTHOR]