Neurology-Neuroimmunology & Neuroinflammation

Obesity Affects Disease Activity and Progression, Cognitive Functioning, and Quality of Life in People With Multiple Sclerosis
Wu J, Alfredsson L, Olsson T, Hillert JA and Hedström AK
While obesity is a known risk factor of the development of multiple sclerosis (MS), its impact on MS disease progression remains unclear. We aimed to investigate the influence of body mass index (BMI) on disease activity and progression, cognitive performance, and health-related quality of life in patients with MS.
Broad Analysis of Serum and Intrathecal Antimicrobial Antibodies in Multiple Sclerosis Underscores Unique Role of Epstein-Barr Virus
Pache F, Otto C, Wilken D, Lietzow T, Steinhagen K, Grage-Griebenow E, Schindler P, Niederschweiberer M, Wildemann B, Jarius S and Ruprecht K
There is a strong link between Epstein-Barr virus (EBV) and multiple sclerosis (MS), but the underlying mechanisms are unclear. Patients with MS typically have a polyspecific intrathecal production of immunoglobulin G (IgG), part of which is directed against various microbial antigens. In this study, we comprehensively analyzed seroprevalences and frequencies of an intrathecal IgG production to EBV compared with 10 other common microbes in patients with MS.
Autoantibodies Against Dihydrolipoamide S-Acetyltransferase Are Not Associated With Immune-Mediated Neuropathies
Jentzer A, El-Bechir J, Taieb G and Devaux JJ
Dihydrolipoamide S-acetyltransferase (DLAT), the E2 component of the mitochondrial pyruvate dehydrogenase complex (PDC-E2), has recently been suggested to be a biomarker of chronic inflammatory demyelinating polyneuropathy (CIDP). It was particularly associated with sensory variants of CIDP. Antimitochondrial antibodies are important for the diagnosis of primary biliary cholangitis, but insofar, only 2 studies have reported an association with CIDP. Here, we aimed to validate these observations in a cohort of French patients with immune-mediated neuropathy.
Proteomics Reveals Age as Major Modifier of Inflammatory CSF Signatures in Multiple Sclerosis
Held F, Makarov C, Gasperi C, Flaskamp M, Grummel V, Berthele A and Hemmer B
Multiple sclerosis (MS) can start as relapsing or progressive. While their clinical features and treatment responses are distinct, it has remained uncertain whether their pathomechanisms differ. A notable age-related effect on MS phenotype and response to immunotherapies is well acknowledged, but the underlying pathophysiologic reasons are yet to be fully elucidated. We aimed to identify disease-specific and age-related proteomic signatures using a comprehensive targeted proteomic analysis.
Spectrum of Clinical and Imaging Features of Children With GFAP Astrocytopathy
Sommer S, Panzer A, Bertolini A, Cleaveland R, Jain V, Kapanci T, Derichs U, Geis T, Neu A, Löhr-Nilles C, Aeschimann-Huhn R, Flotats-Bastardas M, Deiva K, Armangue T, Olivé-Cirera G, Kannoth S, Koy A, Meirson H, Fattal-Valevski A, Ganelin-Cohen E, Losch H, Horne A, Wickström R, Dargvainiene J, Leypoldt F and Rostasy K
Glial fibrillary acidic protein (GFAP) antibodies (abs) have been described primarily in adults with a spectrum of autoimmune-mediated diseases. In children, data on clinical and neuroradiologic features of children with autoimmune GFAP astrocytopathy are limited. The aim of this study was to describe the clinical and radiologic features in children with GFAP-ab-associated diseases.
Pediatric MOG-Ab-Associated Encephalitis: Supporting Early Recognition and Treatment
The Role of Complement Activation in IgM M-Protein-Associated Neuropathies
van de Mortel JPM, Budding K, Dijkxhoorn K, Minnema MC, Vrancken AFJE, Notermans NC, van der Pol WL and
Polyneuropathy associated with an immunoglobulin M (IgM) monoclonal gammopathy is characterized by slowly progressive, predominantly distal sensorimotor deficits, sensory ataxia, and electrophysiologic features of demyelination. IgM antibodies against myelin-associated glycoprotein (MAG) are present in serum from most patients. Nerve damage most likely results from the concerted action of binding of anti-MAG antibodies to nerves, followed by complement activation. The interaction of anti-MAG antibodies with complement activation and their relation to clinical characteristics have not been studied in detail. We studied the correlation among anti-MAG antibody titers, complement activation, and IgM-associated polyneuropathy disease severity.
Microstructural Damage and Repair in the Spinal Cord of Patients With Early Multiple Sclerosis and Association With Disability at 5 Years
Gaubert M, Combès B, Bannier E, Masson A, Caron V, Baudron G, Ferré JC, Michel L, Le Page E, Stankoff B, Edan G, Bodini B and Kerbrat A
The dynamics of microstructural spinal cord (SC) damage and repair in people with multiple sclerosis (pwMS) and their clinical relevance have yet to be explored. We set out to describe patient-specific profiles of microstructural SC damage and change during the first year after MS diagnosis and to investigate their associations with disability and SC atrophy at 5 years.
Temporal Dynamics of Plasma Neurofilament Light in Blood Donors With Preclinical Multiple Sclerosis
Britze J, Larsen MH, Pedersen AG, Rosthøj S, Bach Søndergaard H, Magyari M, Pedersen OB, Jensen BA, Ostrowski SR, Erikstrup C, Ullum H, Battistini JLF, Sellebjerg F and Modvig S
Multiple sclerosis (MS) is a CNS disease, characterized by demyelination, inflammation, and neurodegeneration. Recent advances in technology allow measurement of the axonal damage marker neurofilament light chain in peripheral blood. Two studies have shown that patients with MS have elevated neurofilament light levels before their first symptom, but longitudinal studies are lacking. We aimed to investigate the intraindividual neurofilament light dynamics during the presymptomatic phase of MS.
Missing Full Disclosures
Proteomic Profiling and Pathophysiological Implications in Multiple Sclerosis
Wilson MR and Abdelhak A
Ravulizumab and Efgartigimod in Myasthenia Gravis: A Real-World Study
Stascheit F, Sousa CDF, Aigner A, Behrens M, Keller CW, Klotz L, Lehnerer S, Stein M, Herdick M, Doksani P, Gerischer LM, Hoffmann S, Lazaridis K, Tzartos J, Wiendl H, Meisel A and Lünemann JD
Biologics that target pathogenic antibodies (Abs) and their effector functions such as the complement inhibitor ravulizumab and the neonatal Fc receptor agonist efgartigimod have recently been approved for the treatment of acetylcholine receptor (AChR)-Ab-positive myasthenia gravis (MG), but comparative studies are lacking.
"Lupus Myelitis" Revisited: A Retrospective Single-Center Study of Myelitis Associated With Rheumatologic Disease
Krett JD, Filippatou AG, Barreras P, Pardo CA, Gelber AC and Sotirchos ES
Previous reports of patients with myelitis associated with rheumatologic disease may have had unrecognized aquaporin-4 (AQP4)-IgG seropositive neuromyelitis optica spectrum disorder (NMOSD) or myelin oligodendrocyte glycoprotein (MOG)-IgG-associated disease (MOGAD). We clinicoradiologically and serologically characterized patients with myelitis associated with rheumatologic disease evaluated in the era of availability of MOG-IgG and more sensitive AQP4-IgG cell-based assays.
Cognitive Impairment, Associated Clinical Factors, and MR Volumetric Measures in Myelin Oligodendrocyte Glycoprotein-IgG-Associated Disease
Kogel AK, Ladopoulos T, Schwake C, Kleiter I, Teegen B, Siems N, Prehn C, Lichtenberg S, Ringelstein M, Aktas O, Pul R, Krieger B, Lukas C, Penner IK, Gold R, Schneider R and Ayzenberg I
Cognitive impairment is a common and challenging symptom in multiple sclerosis and neuromyelitis optica spectrum disease; however, data in myelin oligodendrocyte glycoprotein-IgG-associated disease (MOGAD) remain scarce. In this cross-sectional study, we investigated the frequency of cognitive impairment, associated clinical factors, and MRI volumetric measures in MOGAD.
Pharmacokinetics and Pharmacodynamics of Natalizumab 6-Week Dosing vs Continued 4-Week Dosing for Relapsing-Remitting Multiple Sclerosis
Foley JF, Defer G, Ryerson LZ, Cohen JA, Arnold DL, Butzkueven H, Cutter GR, Giovannoni G, Killestein J, Wiendl H, Li K, Dsilva L, Toukam M, Ferber K, Sohn J, Engelman H and Lasky T
Exposure to natalizumab, an efficacious treatment for relapsing-remitting multiple sclerosis (RRMS), is associated with increased risk of progressive multifocal leukoencephalopathy (PML). Compared with every-4-week (Q4W) dosing, extended-interval dosing of natalizumab is associated with decreased risk of PML. Clinical efficacy was maintained in the majority of patients switched to every-6-week (Q6W) dosing in the phase 3b NOVA clinical trial. In this article, we report pharmacokinetics (PK) and pharmacodynamics (PD) of Q6W vs Q4W dosing in NOVA.
Pediatric MOG-Ab-Associated Encephalitis: Supporting Early Recognition and Treatment
Kim NN, Champsas D, Eyre M, Abdel-Mannan O, Lee V, Skippen A, Chitre MV, Forsyth R, Hemingway C, Kneen R, Lim M, Ram D, Ramdas S, Wassmer E, West S, Wright S, Biswas A, Mankad K, Flanagan EP, Palace J, Rossor T, Ciccarelli O and Hacohen Y
Antibodies to myelin oligodendrocyte glycoprotein (MOG-Ab) have recently been reported in patients with encephalitis who do not fulfill criteria for acute disseminated encephalomyelitis (ADEM). We evaluated a cohort of these children and compared them with children with ADEM.
Disease Activity in Pregnant and Postpartum Women With Multiple Sclerosis Receiving Ocrelizumab or Other Disease-Modifying Therapies
Yeh WZ, Van Der Walt A, Skibina OG, Kalincik T, Alroughani R, Kermode AG, Fabis-Pedrini MJ, Carroll WM, Lechner-Scott J, Boz C, Ozakbas S, Buzzard K, Habek M, John NA, Prat A, Girard M, Duquette P, Baghbanian SM, Hodgkinson S, Van Pesch V, Laureys G, Willekens B, Prevost J, Foschi M, De Gans K, Horakova D, Havrdova EK, Karabudak R, Patti F, Mccombe PA, Maimone D, Altintas A, Ampapa R, Spitaleri D, Gerlach OHH, Sa MJ, Hughes S, Gouider R, Mrabet S, Macdonell RA, Turkoglu R, Cartechini E, Al-Asmi A, Soysal A, Oh J, Muros-Le Rouzic E, Guye S, Pasquarelli N, Butzkueven H, Jokubaitis VG and
Women with multiple sclerosis (MS) are at risk of disease reactivation in the early postpartum period. Ocrelizumab (OCR) is an anti-CD20 therapy highly effective at reducing MS disease activity. Data remain limited regarding use of disease-modifying therapies (DMTs), including OCR, and disease activity during peripregnancy periods.
Choroid Plexus Volume in Pediatric-Onset Multiple Sclerosis
Grasso EA, Bloy L, Kaplan P, Bar-Or A, Yeh EA, Arnold DL, Narayanan S, Marrie RA, Fadda G, Banwell BL and
Recent studies suggest that the choroid plexus (CP) may function as a site of access of inflammatory cells into the CNS in multiple sclerosis (MS). Pediatric-onset MS (POMS) is characterized by a high inflammatory burden, as evidenced by a high relapse rate and volume of T2 lesions, making patients with POMS an informative population to evaluate choroid plexus volume (CPV). The objectives of the study were (1) to evaluate CPV at symptom onset in participants with POMS compared with healthy controls (HCs); (2) to evaluate changes in CPV in the first year of disease in participants with POMS; and (3) to evaluate associations between CPV, brain volumes, relapse activity, and disability in participants with POMS.
Autoimmune Encephalitis and Paraneoplastic Neurologic Syndromes: A Nationwide Study on Epidemiology and Antibody Testing Performance
Kerstens J, Schreurs MWJ, de Vries JM, Neuteboom RF, Brenner J, Crijnen YS, van Steenhoven RW, de Bruijn MAAM, van Sonderen A, van Coevorden-Hameete MH, Bastiaansen AEM, Vermeiren MR, Damoiseaux JGMC, Otten HG, Frijns CJM, Meek B, Platteel ACM, van de Mortel A, Delnooz CCS, Broeren MAC, Verbeek MM, Hoff EI, Boukhrissi S, Franken SC, Nagtzaam MMP, Paunovic M, Veenbergen S, Sillevis Smitt PAE and Titulaer MJ
Autoimmune encephalitis (AIE) and paraneoplastic neurologic syndromes (PNSs) encompass a heterogeneous group of antibody-associated disorders. Both the number of syndromes and commercially available antibody tests have increased considerably over the past decade. High-quality population-based data on epidemiology of these disorders and real-world performance of antibody tests are needed.
Multiple Sclerosis Patient Macrophages Impaired Metabolism Leads to an Altered Response to Activation Stimuli
Fransson J, Bachelin C, Ichou F, Guillot-Noël L, Ponnaiah M, Gloaguen A, Maillart E, Stankoff B, Tenenhaus A, Fontaine B, Mochel F, Louapre C and Zujovic V
In multiple sclerosis (MS), immune cells invade the CNS and destroy myelin. Macrophages contribute to demyelination and myelin repair, and their role in each process depends on their ability to acquire specific phenotypes in response to external signals. In this article, we assess whether defects in MS patient macrophage responses may lead to increased inflammation or lack of neuroregenerative effects.
Immunologic Profiling of CSF in Subarachnoid Neurocysticercosis Reveals Specific Interleukin-10-Producing Cell Populations During Treatment
Tang NL, Schaughency P, Gazzinelli-Guimaraes P, Lack J, Thumm L, Miltenberger E, Nash TE, Nutman TB and O'Connell EM
Subarachnoid neurocysticercosis (SANCC) is the most severe form of CNS infection and accounts for the majority of neurocysticercosis-associated mortality. Inflammation is important in the treatment of SANCC because overactivity can lead to serious complications, but excessive suppression may be counterproductive toward parasite eradication. A relative abundance of CSF IL-10 to IL-12 has been associated with increased treatment duration for patients with SANCC, suggesting that IL-10 plays an important role in this disease process. To better understand SANCC immunology and the major sources of IL-10 during anthelmintic treatment, we took an unbiased and comprehensive approach to phenotype the immune cell populations in the CSF and peripheral blood of patients with SANCC.