Central nervous system neuroinflammatory disorders in Asian/Pacific regions

Kim, Suhyun; Kim, Ho Jin

doi:10.1097/wco.0000000000000315

Cited by 16 publications

(13 citation statements)

References 130 publications

(150 reference statements)

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“…A study conducted in Australia and New Zealand showed that NMOSD was three times more prevalent in individuals with Asian ancestry than in the remaining population with predominantly European ancestry ( 9 ). In addition, the NMOSD/multiple sclerosis ratio has been reported to be higher in Asia than in Western countries ( 10 ). A recent study using data from a large international cohort of adult patients with NMOSD revealed that race affected the clinical phenotype, age at onset, and severity of attacks, but the overall clinical outcome was most dependent on early and effective immunosuppressive treatment initiation ( 11 ).…”

Section: Review Of Current Knowledgementioning

confidence: 99%

Pediatric NMOSD: A Review and Position Statement on Approach to Work-Up and Diagnosis

Tenembaum

Yeh

2020

Front. Pediatr.

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Neuromyelitis Optica Spectrum Disorder (NMOSD) is an inflammatory demyelinating disease of the central nervous system (CNS) primarily affecting the optic nerves and spinal cord, but also involving other regions of the CNS including the area postrema, periaqueductal gray matter, and hypothalamus. Knowledge related to pediatric manifestations of NMOSD has grown in recent years, particularly in light of newer information regarding the importance of not only antibodies to aquaporin 4 (AQP4-IgG) but also myelin oligodendrocyte glycoprotein (MOG-IgG) in children manifesting clinically with this syndrome. In this review, we describe the current state of the knowledge related to clinical manifestations, diagnosis, and chronic therapies for children with NMOSD, with emphasis on literature that has been published in the last 5 years. Following the review, we propose recommendations for the assessment/follow up clinical care, and treatment of this population.

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Section: Review Of Current Knowledgementioning

confidence: 99%

Pediatric NMOSD: A Review and Position Statement on Approach to Work-Up and Diagnosis

Tenembaum

Yeh

2020

Front. Pediatr.

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“…We estimated the pooled AQP4-IgG and MOG-IgG prevalence in isolated ON separately for Asian and non-Asian populations, given the divergence of prevalence between studies in these populations, and evidence supporting higher prevalence of NMOSD in Asian populations ( 10 ). Given the relatively low prevalence of these disorders in some of the included studies (estimates close to 0%), we utilized the variance-stabilizing double arcsine transformation method ( 19 ).…”

Section: Methodsmentioning

confidence: 99%

“…In patients presenting with classic neuromyelitis optica (NMO) or acute disseminated encephalomyelitis (ADEM)-like phenotypes, clinical suspicion for AQP4-IgG- or MOG-IgG-associated disease is high, but diagnosis may be challenging and delayed in limited forms, such as isolated ON. Notably, the reported prevalence of AQP4-IgG and MOG-IgG seropositivity among patients presenting with isolated ON varies significantly between studies, and the available literature suggests that seropositivity for these antibodies is more common in non-white populations with ON ( 9 , 10 ).…”

Section: Introductionmentioning

confidence: 99%

AQP4-IgG and MOG-IgG Related Optic Neuritis—Prevalence, Optical Coherence Tomography Findings, and Visual Outcomes: A Systematic Review and Meta-Analysis

et al. 2020

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Background: Optic neuritis (ON) is a cardinal manifestation of multiple sclerosis (MS), aquaporin-4 (AQP4)-IgG-, and myelin oligodendrocyte glycoprotein (MOG)-IgG-associated disease. However, the prevalence of AQP4-IgG seropositivity and MOG-IgG seropositivity in isolated ON is unclear, and studies comparing visual outcomes and optical coherence tomography (OCT)-derived structural retinal measures between MS-ON, AQP4-ON, and MOG-ON eyes are limited by small sample sizes. Objectives: (1) To assess the prevalence of AQP4-IgG and MOG-IgG seropositivity among patients presenting with isolated ON; (2) to compare visual outcomes and OCT measures between AQP4-ON, MOG-ON, and MS-ON eyes. Methods: In this systematic review and meta-analysis, a total of 65 eligible studies were identified by PubMed search. Statistical analyses were performed with random effects models. Results: In adults with isolated ON, AQP4-IgG seroprevalence was 4% in non-Asian and 27% in Asian populations, whereas MOG-IgG seroprevalence was 8 and 20%, respectively. In children, AQP4-IgG seroprevalence was 0.4% in non-Asian and 15% in Asian populations, whereas MOG-IgG seroprevalence was 47 and 31%, respectively. AQP4-ON eyes had lower peri-papillary retinal nerve fiber layer (pRNFL; −11.7 μm, 95% CI: −15.2 to −8.3 μm) and macular ganglion cell + inner plexiform layer (GCIPL; −9.0 μm, 95% CI: −12.5 to −5.4 μm) thicknesses compared with MS-ON eyes. Similarly, pRNFL (−11.2 μm, 95% CI: −21.5 to −0.9 μm) and GCIPL (−6.1 μm, 95% CI: −10.8 to −1.3 μm) thicknesses were lower in MOG-ON compared to MS-ON eyes, but did not differ between AQP4-ON and MOG-ON eyes (pRNFL: −1.9 μm, 95% CI: −9.1 to 5.4 μm; GCIPL: −2.6 μm, 95% CI: −8.9 to 3.8 μm). Visual outcomes were worse in AQP4-ON compared to both MOG-ON (mean logMAR difference: 0.60, 95% CI: 0.39 to 0.81) and MS-ON eyes (mean logMAR difference: 0.68, 95% CI: 0.40 to 0.96) but were similar in MOG-ON and MS-ON eyes (mean logMAR difference: 0.04, 95% CI: −0.05 to 0.14). Conclusions: AQP4-IgG- and MOG-IgG-associated disease are important diagnostic considerations in adults presenting with isolated ON, especially in Asian populations. Furthermore, MOG-IgG seroprevalence is especially high in pediatric isolated ON, in both non-Asian and Asian populations. Despite a similar severity of GCIPL and pRNFL thinning in AQP4-ON and MOG-ON, AQP4-ON is associated with markedly worse visual outcomes.

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“…4 The NMOSD/ multiple sclerosis ratio is reported to be higher in Asia than in Western countries. 5 Therefore, comparative studies across different races are needed to determine whether the epidemiologic differences observed reflect true racial differences in the NMOSD phenotype and prognosis.…”

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confidence: 99%

Racial differences in neuromyelitis optica spectrum disorder

et al. 2018

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ObjectiveWe aimed to evaluate racial differences in the clinical features of neuromyelitis optica spectrum disorder.MethodsThis retrospective review included 603 patients (304 Asian, 207 Caucasian, and 92 Afro-American/Afro-European), who were seropositive for anti–aquaporin-4 antibody, from 6 centers in Denmark, Germany, South Korea, United Kingdom, United States, and Thailand.ResultsMedian disease duration at last follow-up was 8 years (range 0.3–38.4 years). Asian and Afro-American/Afro-European patients had a younger onset age than Caucasian patients (mean 36, 33, and 44 years, respectively; p < 0.001). During the disease course, Caucasian patients (23%) had a lower incidence of brain/brainstem involvement than Asian (42%) and Afro-American/Afro-European patients (38%) (p < 0.001). Severe attacks (visual acuity ≤0.1 in at least one eye or Expanded Disability Status Scale score ≥6.0 at nadir) at onset occurred more frequently in Afro-American/Afro-European (58%) than in Asian (46%) and Caucasian (38%) patients (p = 0.005). In the multivariable analysis, older age at onset, higher number of attacks before and after immunosuppressive treatment, but not race, were independent predictors of severe motor disabilities at last follow-up.ConclusionA review of a large international cohort revealed that race affected the clinical phenotype, age at onset, and severity of attacks, but the overall outcome was most dependent on early and effective immunosuppressive treatment.

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Central nervous system neuroinflammatory disorders in Asian/Pacific regions

Abstract: The understanding of CNS neuroinflammatory disorders in Asian/Pacific regions continues to evolve owing to the discovery of new biological markers and recognition of broader clinical phenotypes.

Cited by 16 publications

References 130 publications

Pediatric NMOSD: A Review and Position Statement on Approach to Work-Up and Diagnosis

Pediatric NMOSD: A Review and Position Statement on Approach to Work-Up and Diagnosis

AQP4-IgG and MOG-IgG Related Optic Neuritis—Prevalence, Optical Coherence Tomography Findings, and Visual Outcomes: A Systematic Review and Meta-Analysis

Racial differences in neuromyelitis optica spectrum disorder

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