Silent New Brain MRI Lesions in Children with MOG-Antibody Associated Disease

Giulia Fadda; Brenda Banwell; Patrick Waters; Ruth A Marrie; E Ann Yeh; Julia O'Mahony; Douglas A Arnold; Amit Bar-Or; Canadian Pediatric Demyelinating Disease Network

doi:10.1002/ana.25957

Silent New Brain MRI Lesions in Children with MOG-Antibody Associated Disease

Ann Neurol. 2021 Feb;89(2):408-413. doi: 10.1002/ana.25957. Epub 2020 Nov 30.

Authors

Affiliations

¹ Center for Neuroinflammation and Neurotherapeutics, and Multiple Sclerosis Division, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
² Division of Child Neurology, Department of Neurology, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
³ Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
⁴ Departments of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
⁵ Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
⁶ Institute of Health Policy, Management and Evaluation, the University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada.
⁷ Montreal Neurological Institute, McGill University, Montreal, QC, Canada.

PMID: 33210746
DOI: 10.1002/ana.25957

Abstract

Anti-myelin oligodendrocyte glycoprotein immunoglobulin G (MOG-IgG) antibodies are associated clinically with either a monophasic or relapsing disease course. We investigated the frequency and clinical importance of acquired asymptomatic brain magnetic resonance imaging (MRI) lesions in a prospective incident cohort of 74 MOG-IgG positive children with serial MRI scans over a median of 5 years from presentation. Silent new lesions were detected in 14% of MOG-IgG positive participants, most commonly within the first months post-onset, with a positive predictive value for clinically relapsing disease of only 20%. Detection of asymptomatic lesions alone need not prompt initiation of chronic immunotherapy. ANN NEUROL 2021;89:408-413.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Asymptomatic Diseases*
Autoantibodies / immunology*
Brain / diagnostic imaging*
Brain / physiopathology
Child
Demyelinating Autoimmune Diseases, CNS / diagnostic imaging*
Demyelinating Autoimmune Diseases, CNS / immunology
Demyelinating Autoimmune Diseases, CNS / physiopathology
Demyelinating Autoimmune Diseases, CNS / therapy
Encephalomyelitis, Acute Disseminated / diagnostic imaging*
Encephalomyelitis, Acute Disseminated / immunology
Encephalomyelitis, Acute Disseminated / physiopathology
Encephalomyelitis, Acute Disseminated / therapy
Female
Glucocorticoids / therapeutic use
Humans
Immunoglobulin G
Immunoglobulins, Intravenous / therapeutic use
Immunologic Factors / therapeutic use
Immunotherapy
Magnetic Resonance Imaging
Male
Multiple Sclerosis / diagnostic imaging*
Multiple Sclerosis / immunology
Multiple Sclerosis / physiopathology
Multiple Sclerosis / therapy
Myelin-Oligodendrocyte Glycoprotein / immunology*
Oligoclonal Bands / cerebrospinal fluid
Plasma Exchange
Recurrence

Substances

Autoantibodies
Glucocorticoids
Immunoglobulin G
Immunoglobulins, Intravenous
Immunologic Factors
Myelin-Oligodendrocyte Glycoprotein
Oligoclonal Bands