Impaired Brain Growth in Myelin Oligodendrocyte Glycoprotein Antibody–Associated Acute Disseminated Encephalomyelitis. Issue 2 (8th March 2023)

• Record Type: Journal Article
• Authors: Bartels, Frederik; Baumgartner, Birgit; Aigner, Annette; Cooper, Graham; Blaschek, Astrid; Wendel, Eva Maria; Bertolini, Annikki; Karenfort, Michael; Baumann, Matthias; Cleaveland, Robert; Wegener-Panzer, Andreas; Leiz, Steffen; Salandin, Michela; Krieg, Peter; Reindl, Tobias; Reindl, Markus; Finke, Carsten; Rostásy, Kevin
• Is Part Of: Neurology. Volume 10:Issue 2(2023)
• Publication Date: 2023-03-08
• Subjects: Neuroimmunology -- Periodicals; Neurology -- Periodicals; 616.8
• DOI: 10.1212/NXI.0000000000200066
• Languages: English
• ISSNs: 2332-7812

Abstract

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 cm 3 [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 cm 3 [95% CI −193.6 to −82.9]) than MOG-positive patients (−50.0 cm 3 [−126.5 to −5.2]), independent of age, sex, and treatment. Relapsing patients (all MOG positive) showed additional brain volume loss (−15.8 cm 3 [−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.