ABSTRACT: The detection of reactivity against autoantigens plays a crucial role in the diagnosis of autoimmune diseases. However, only a few autoantibodies are known in each disease, and their precise targets are often not precisely defined. In neuromyelitis optica (NMO), an autoimmune disease of the central nervous system, anti-aquaporin 4 antibodies are currently the only available immunological markers, although they are not detected in 10-50% of patients. Using enzyme-linked immunosorbent assays, we evaluated the reactivity against 19 structurally defined peptides in 26 NMO sera compared with 21 healthy subjects. We observed increased levels of IgG against myelin basic protein sequence MBP(156-175), pyruvate dehydrogenase sequence PDH(167-186) and CSF114(Glc), the last of these having a possible correlation with onset of inflammatory relapse. These preliminary results may suggest that the aquaporin 4 is not the unique target in NMO and that the study of reactivity against these peptides would be helpful for the diagnosis and follow-up of the disease. Complementary studies are however warranted to confirm these results. Copyright © 2012 European Peptide Society and John Wiley & Sons, Ltd.
Journal of Peptide Science 11/2012; · 1.80 Impact Factor
ABSTRACT: Neuromyelitis optica (NMO) is an inflammatory disease associated with optic neuritis and myelitis. Although some studies have reported multiple sclerosis (MS)-like lesions in 10-30% of NMO patients, brain MRI is usually normal. Several studies have observed metabolic abnormalities on MR spectroscopy in MS, even in normal-appearing white matter (NAWM). To the authors' knowledge, MR spectroscopy has never been used to investigate NMO. The aim of this study was to evaluate metabolic abnormalities in the NAWM and normal-appearing grey matter (NAGM) of NMO patients.
The authors evaluated 24 patients (17 women and seven men, with a mean age of 44.6 years). NMO was diagnosed according to revised criteria. All patients had a brain and spinal cord MR imaging including MR spectroscopy sequences in both NAWM and NAGM. Patients were compared with 12 healthy subjects.
NAA/creatinine ratios in NAWM (1.89 + or - 0.26 in NMO compared with 1.91 + or - 0.15 in control subjects) and NAGM (1.62 + or - 0.21 compared with 1.59 + or - 0.18) were normal, as were choline/creatinine ratios in NAWM (1.03 + or - 0.18 compared with 1.08 + or - 0.14) and NAGM (0.89 + or - 0.2 compared with 0.94 + or - 0.2). Myo-inositol values in NAWM were also normal (0.42 + or - 0.12 compared with 0.42 + or - 0.18).
Our results are clearly different from those found in MS, where NAA is frequently decreased and choline increased, even in NAWM. Our findings could have an impact on the differentiation between MS and NMO.
Journal of neurology, neurosurgery, and psychiatry 04/2010; 81(4):409-11. · 4.87 Impact Factor
ABSTRACT: Neuromyelitis optica (NMO) is an inflammatory disease with combined features of optic neuritis and myelitis. This pathologic entity may induce severe disability, including visual loss and paraplegia. Other than clinical follow-up, there is no marker for severity of the disease.
To evaluate the use of optical coherence tomography (OCT) in NMO and to determine whether this new technique could be a good marker of axonal loss in NMO.
Thirty-five patients with NMO or at a high risk for NMO (having optic neuritis or myelitis and who are positive for NMO antibody) were prospectively studied. Fifteen healthy individuals served as control subjects.
All patients underwent a complete ophthalmologic evaluation, including OCT, funduscopy, and visual field, visual acuity, and visual evoked potential testing. Expanded Disability Status Scale scores were assessed but without the visual data. Correlations between the visual test results and demographic or clinical characteristics were evaluated.
Optical coherence tomography and visual field data were available for only 32 patients because 3 patients were blind. The mean retinal nerve fiber layer thickness was significantly reduced in patients with NMO compared with controls (P < .001). We found good correlation between the OCT results and visual field testing. We also found weak correlation between OCT results and both visual acuity and visual evoked potential latencies. We did not find any correlation between OCT results and age, sex, or disease duration. In contrast, retinal nerve fiber layer thickness was closely correlated with the Expanded Disability Status Scale score (P < .001).
Optical coherence tomography results are significantly altered in patients with NMO. Optical coherence tomography is easy to perform, and the results are well correlated with visual acuity and visual field findings. It could be considered a marker of axonal loss because we found good correlation between OCT and the Expanded Disability Status Scale score. These preliminary results will need to be confirmed in a longitudinal prospective study.
Archives of neurology 07/2008; 65(7):920-3. · 6.31 Impact Factor
ABSTRACT: Neuromyelitis optica (NMO) is characterized by optic neuritis and longitudinally extensive acute transverse myelitis. The brain is generally considered healthy in NMO, though very recent studies have demonstrated that magnetic resonance imaging abnormalities may be observed in various brain regions of NMO patients. To date, cognitive functions have never been investigated in NMO.
To investigate cognitive functions in a cohort of 30 patients with NMO.
Observational, prospective study.
We studied 30 patients with NMO and compared them with 30 patients with multiple sclerosis and 30 healthy controls matched for age, sex, and educational level. Main Outcome Measure We applied a French translation of the Brief Repeatable Battery of Neuropsychological Tests for Multiple Sclerosis and 3 additional tests.
Cognitive performance was significantly lower in the NMO and multiple sclerosis groups than in healthy controls for the 2-second (P< .001) and 3-second (P= .001) Paced Auditory Serial Addition Test, the digit symbol modality test (P= .005), word generation (P= .02), and forward (P= .002) and backward (P= .007) digit span test. We did not observe any difference in test performance between NMO and multiple sclerosis patients. We found no differences between the 3 groups for the other tests. We did not find any correlation between clinical, biological, or magnetic resonance imaging results and cognitive dysfunction.
This study confirms the recent concept of a possible brain involvement in NMO. Additional studies are needed to confirm these initial results and to better understand the mechanisms of such abnormalities.
Archives of Neurology 01/2008; 65(1):84-8. · 7.58 Impact Factor
Annals of internal medicine 02/2007; 146(2):150-1. · 16.73 Impact Factor