A preliminary study on characteristics of visual evoked potentials in children with myelin oligodendrocyte glycoprotein immunoglobulin G associated disorders in the acute phase

  • Jinxiao CHEN ,
  • Jing SUN ,
  • Wenmin YANG ,
  • Xiaoyue WANG ,
  • Xin WANG ,
  • Jian YANG
Expand
  • Department of Neurology, Children's Hospital Affiliated to The Capital Institute of Pediatrics, Beijing 100020, China

Received date: 2021-08-30

  Online published: 2022-04-07

Abstract

Objective To investigate the characteristics of visual evoked potentials (VEP) in children with MOG-IgG associated disorders (MOGAD) in the acute phase.Methods The clinical data of children admitted from May 2018 to February 2020 who were clinically diagnosed with central nervous system idiopathic inflammatory demyelinating diseases (CNS-IIDDs) were retrospectively analyzed. The children were divided into different groups according to the results of serum MOG-antibody detection and whether the optic nerve was involved clinically. The characteristics of VEP between different groups were analyzed.Results Among 67 children with CNS-IIDDS, 29 (43.3%) were in the MOG antibody positive group, and 15 (51.7%) had optic neuritis. There were 38 (56.7%) children in the MOG antibody negative group, and 19 (50.0%) had optic neuritis. The VEP test was examined on both eyes of all children, including 58 eyes in the MOG antibody positive group and 76 eyes in the MOG antibody negative group, obtaining VEP results of 134 eyes in total. Among the 66 eyes in the non-optic neuritis group, the abnormal rate of VEP in the MOG antibody positive group (14/28, 50.0%) was significantly higher than that in the MOG antibody negative group (9/38, 23.7%), and the difference was statistically significant (P<0.05). In the 68 eyes of the optic neuritis group, the proportion of blindness and severe vision impairment in the MOG antibody positive group was higher than that in the MOG antibody seronegative group, and the difference was statistically significant (P<0.05). In 58 eyes of MOG antibody positive group, there was significant difference in the abnormal rate of VEP between groups with different MOG antibody titer (P<0.05). The abnormal rate of VEP increased with the increase of MOG antibody titer.Conclusions VEP can effectively detect subclinical lesions of optic nerve in MOGAD. The probability of visual pathway damage may be higher under the conditions of high MOG antibody titers.

Cite this article

Jinxiao CHEN , Jing SUN , Wenmin YANG , Xiaoyue WANG , Xin WANG , Jian YANG . A preliminary study on characteristics of visual evoked potentials in children with myelin oligodendrocyte glycoprotein immunoglobulin G associated disorders in the acute phase[J]. Journal of Clinical Pediatrics, 2022 , 40(4) : 284 -289 . DOI: 10.12372/jcp.2022.21e1251

References

[1] Reindl M, Waters P. Myelin oligodendrocyte glycoprotein antibodies in neurological disease[J]. Nat Rev Neurol, 2019, 15(2):89-102.
[2] de Mol CL, Wong Y, van Pelt ED, et al. The clinical spectrum and incidence of anti-MOG-associated acquired demyelinating syndromes in children and adults[J]. Mult Scler, 2020, 26(7):806-814.
[3] Jarius S, Paul F, Aktas O, et al. MOG encephalomyelitis: international recommendations on diagnosis and antibody testing[J]. J Neuroinflammation, 2018, 15(1):134.
[4] 中国免疫学会神经免疫分会. 抗髓鞘少突胶质细胞糖蛋白免疫球蛋白G抗体相关疾病诊断和治疗中国专家共识[J]. 中国神经免疫学和神经病学杂志, 2020, 27(2):86-95.
[5] Fernandez-Carbonell C, Vargas-Lowy D, Musallam A, et al. Clinical and MRI phenotype of children with MOG antibodies[J]. Mult Scler, 2016, 22(2):174-184.
[6] Waters P, Fadda G, Woodhall M, et al. Serial anti-myelin oligodendrocyte glycoprotein antibody analyses and outcomes in children with demyelinating syndromes[J]. JAMA Neurol, 2020, 77(1):82-93.
[7] Jurynczyk M, Messina S, Woodhall MR, et al. Clinical presentation and prognosis in MOG-antibody disease: a UK study[J]. Brain, 2017, 140(12):3128-3138.
[8] Ramanathan S, Mohammad S, Tantsis E, et al. Clinical course, therapeutic responses and outcomes in relapsing MOG antibody-associated demyelination[J]. J Neurol Neurosurg Psychiatry, 2018, 89(2):127-137.
[9] Krupp LB, Tardieu M, Amato MP, et al. International Pediatric Multiple Sclerosis Study Group criteria for pediatric multiple sclerosis and immune-mediated central nervous system demyelinating disorders: revisions to the 2007 definitions[J]. Mult Scler, 2013, 19(10):1261-1267.
[10] 中华医学会眼科学分会神经眼科学组. 视神经炎诊断和治疗专家共识(2014年)[J]. 中华眼科杂志, 2014, (6):459-463.
[11] Peschl P, Bradl M, Höftberger R, et al. Myelin oligo-dendrocyte glycoprotein: deciphering a target in inflammatory demyelinating diseases[J]. Front Immunol, 2017, 8:529.
[12] Duignan S, Wright S, Rossor T, et al. Myelin oligo-dendrocyte glycoprotein and aquaporin-4 antibodies are highly specific in children with acquired demyelinating syndromes[J]. Dev Med Child Neurol, 2018, 60(9):958-962.
[13] 潘映辐. 临床诱发电位学 [M]. 2版. 北京: 人民卫生出版社, 2000.
[14] Jarius S, Ruprecht K, Kleiter I, et al. MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 2: epidemiology, clinical presentation, radiological and laboratory features, treatment responses, and long-term outcome[J]. J Neuroinflammation, 2016, 13(1):280.
[15] Salama S, Khan M, Levy M, et al. Radiological cha-racteristics of myelin oligodendrocyte glycoprotein antibody disease[J]. Mult Scler Relat Disord, 2019, 29:15-22.
[16] Ramanathan S, Prelog K, Barnes EH, et al. Radiological differentiation of optic neuritis with myelin oligodendrocyte glycoprotein antibodies, aquaporin-4 antibodies, and multiple sclerosis[J]. Mult Scler, 2016, 22(4):470-482.
[17] Hennes EM, Baumann M, Schanda K, et al. Prognostic relevance of MOG antibodies in children with an acquired demyelinating syndrome[J]. Neurology, 2017, 89(9):900-908.
[18] Tea F, Lopez JA, Ramanathan S, et al. Characterization of the human myelin oligodendrocyte glycoprotein antibody response in demyelination[J]. Acta Neuropathol Commun, 2019, 7(1):145.
[19] Jarius S, Ruprecht K, Kleiter I, et al. MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 1: frequency, syndrome specificity, influence of disease activity, long-term course, association with AQP4-IgG, and origin[J]. J Neuroinflammation, 2016, 13(1):279.
[20] Cobo-Calvo A, Sepúlveda M, D'Indy H, et al. Usefulness of MOG-antibody titres at first episode to predict the future clinical course in adults[J]. J Neurol, 2019, 266(4):806-815.
Outlines

/