Myelitis features and outcomes in CNS demyelinating disorders: Comparison between multiple sclerosis, MOGAD, and AQP4-IgG-positive NMOSD
Inflammatory myelopathies can manifest with a combination of motor, sensory and autonomic dysfunction of variable severity. Depending on the underlying etiology, the episodes of myelitis can recur, often leading to irreversible spinal cord damage and major long-term disability. Three main demyelinat...
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| Format: | Article |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.1011579/full |
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| author | Giulia Fadda Eoin P. Flanagan Eoin P. Flanagan Laura Cacciaguerra Laura Cacciaguerra Jiraporn Jitprapaikulsan Paolo Solla Pietro Zara Elia Sechi |
| author_facet | Giulia Fadda Eoin P. Flanagan Eoin P. Flanagan Laura Cacciaguerra Laura Cacciaguerra Jiraporn Jitprapaikulsan Paolo Solla Pietro Zara Elia Sechi |
| author_sort | Giulia Fadda |
| collection | DOAJ |
| description | Inflammatory myelopathies can manifest with a combination of motor, sensory and autonomic dysfunction of variable severity. Depending on the underlying etiology, the episodes of myelitis can recur, often leading to irreversible spinal cord damage and major long-term disability. Three main demyelinating disorders of the central nervous system, namely multiple sclerosis (MS), aquaporin-4-IgG-positive neuromyelitis optica spectrum disorders (AQP4+NMOSD) and myelin oligodendrocyte glycoprotein-IgG associated disease (MOGAD), can induce spinal cord inflammation through different pathogenic mechanisms, resulting in a more or less profound disruption of spinal cord integrity. This ultimately translates into distinctive clinical-MRI features, as well as distinct patterns of disability accrual, with a step-wise worsening of neurological function in MOGAD and AQP4+NMOSD, and progressive disability accrual in MS. Early recognition of the specific etiologies of demyelinating myelitis and initiation of the appropriate treatment is crucial to improve outcome. In this review article we summarize and compare the clinical and imaging features of spinal cord involvement in these three demyelinating disorders, both during the acute phase and over time, and outline the current knowledge on the expected patterns of disability accrual and outcomes. We also discuss the potential implications of these observations for patient management and counseling. |
| first_indexed | 2024-04-11T22:54:13Z |
| format | Article |
| id | doaj.art-30c3880e981d444a86678766ce6778a0 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-11T22:54:13Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-30c3880e981d444a86678766ce6778a02022-12-22T03:58:28ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-11-011310.3389/fneur.2022.10115791011579Myelitis features and outcomes in CNS demyelinating disorders: Comparison between multiple sclerosis, MOGAD, and AQP4-IgG-positive NMOSDGiulia Fadda0Eoin P. Flanagan1Eoin P. Flanagan2Laura Cacciaguerra3Laura Cacciaguerra4Jiraporn Jitprapaikulsan5Paolo Solla6Pietro Zara7Elia Sechi8Montreal Neurological Institute, McGill University, Montreal, QC, CanadaDepartment of Neurology, Center for MS and Autoimmune Neurology, Mayo Clinic, Rochester, MN, United StatesDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United StatesDepartment of Neurology, Center for MS and Autoimmune Neurology, Mayo Clinic, Rochester, MN, United StatesDivision of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, ItalyDivision of Neurology, Department of Medicine, Siriraj Hospital, Bangkok, ThailandDepartment of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, ItalyDepartment of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, ItalyDepartment of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, ItalyInflammatory myelopathies can manifest with a combination of motor, sensory and autonomic dysfunction of variable severity. Depending on the underlying etiology, the episodes of myelitis can recur, often leading to irreversible spinal cord damage and major long-term disability. Three main demyelinating disorders of the central nervous system, namely multiple sclerosis (MS), aquaporin-4-IgG-positive neuromyelitis optica spectrum disorders (AQP4+NMOSD) and myelin oligodendrocyte glycoprotein-IgG associated disease (MOGAD), can induce spinal cord inflammation through different pathogenic mechanisms, resulting in a more or less profound disruption of spinal cord integrity. This ultimately translates into distinctive clinical-MRI features, as well as distinct patterns of disability accrual, with a step-wise worsening of neurological function in MOGAD and AQP4+NMOSD, and progressive disability accrual in MS. Early recognition of the specific etiologies of demyelinating myelitis and initiation of the appropriate treatment is crucial to improve outcome. In this review article we summarize and compare the clinical and imaging features of spinal cord involvement in these three demyelinating disorders, both during the acute phase and over time, and outline the current knowledge on the expected patterns of disability accrual and outcomes. We also discuss the potential implications of these observations for patient management and counseling.https://www.frontiersin.org/articles/10.3389/fneur.2022.1011579/fullneuromyelitis optica (NMO)progressive MSmyelin oligodendrocyte glycoprotein (MOG) antibody associated diseasemyelopathyMRI |
| spellingShingle | Giulia Fadda Eoin P. Flanagan Eoin P. Flanagan Laura Cacciaguerra Laura Cacciaguerra Jiraporn Jitprapaikulsan Paolo Solla Pietro Zara Elia Sechi Myelitis features and outcomes in CNS demyelinating disorders: Comparison between multiple sclerosis, MOGAD, and AQP4-IgG-positive NMOSD Frontiers in Neurology neuromyelitis optica (NMO) progressive MS myelin oligodendrocyte glycoprotein (MOG) antibody associated disease myelopathy MRI |
| title | Myelitis features and outcomes in CNS demyelinating disorders: Comparison between multiple sclerosis, MOGAD, and AQP4-IgG-positive NMOSD |
| title_full | Myelitis features and outcomes in CNS demyelinating disorders: Comparison between multiple sclerosis, MOGAD, and AQP4-IgG-positive NMOSD |
| title_fullStr | Myelitis features and outcomes in CNS demyelinating disorders: Comparison between multiple sclerosis, MOGAD, and AQP4-IgG-positive NMOSD |
| title_full_unstemmed | Myelitis features and outcomes in CNS demyelinating disorders: Comparison between multiple sclerosis, MOGAD, and AQP4-IgG-positive NMOSD |
| title_short | Myelitis features and outcomes in CNS demyelinating disorders: Comparison between multiple sclerosis, MOGAD, and AQP4-IgG-positive NMOSD |
| title_sort | myelitis features and outcomes in cns demyelinating disorders comparison between multiple sclerosis mogad and aqp4 igg positive nmosd |
| topic | neuromyelitis optica (NMO) progressive MS myelin oligodendrocyte glycoprotein (MOG) antibody associated disease myelopathy MRI |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.1011579/full |
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