The role of anti-aquaporin 4 antibody in the conversion of acute brainstem syndrome to neuromyelitis optica
Background: Acute brainstem syndrome (ABS) may herald multiple sclerosis (MS), neuromyelitis optica (NMO), or occur as an isolated syndrome. The aquaporin 4 (AQP4)-specific serum autoantibody, NMO-IgG, is a biomarker for NMO. However, the role of anti-AQP4 antibody in the conversion of ABS to NMO is...
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BioMed Central
2016
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| Online Access: | https://eprints.nottingham.ac.uk/47351/ |
| _version_ | 1848797523512131584 |
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| author | Cheng, Chen Jiang, Ying Lu, Xiaodong Gu, Fu Kang, Zhuang Dai, Yongqiang Lu, Zhengqi Hu, Xueqiang |
| author_facet | Cheng, Chen Jiang, Ying Lu, Xiaodong Gu, Fu Kang, Zhuang Dai, Yongqiang Lu, Zhengqi Hu, Xueqiang |
| author_sort | Cheng, Chen |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background: Acute brainstem syndrome (ABS) may herald multiple sclerosis (MS), neuromyelitis optica (NMO), or occur as an isolated syndrome. The aquaporin 4 (AQP4)-specific serum autoantibody, NMO-IgG, is a biomarker for NMO. However, the role of anti-AQP4 antibody in the conversion of ABS to NMO is unclear.
Methods: Thirty-one patients with first-event ABS were divided into two groups according to the presence of anti-AQP4 antibodies, their clinical features and outcomes were retrospectively analyzed.
Results: Fourteen of 31 patients (45.16 %) were seropositive for NMO-IgG. The 71.43 % of anti-AQP4 (+) ABS patients converted to NMO, while only 11.76 % of anti-AQP4 (-) ABS patients progressed to NMO. Anti-AQP4 (+) ABS patients demonstrated a higher IgG index (0.68 ± 0.43 vs 0.42 ± 0.13, p < 0.01) and Kurtzke Expanded Disability Status Scale (4.64 ± 0.93 vs 2.56 ± 0.81, p < 0.01) than anti-AQP4 (-) ABS patients. Area postrema clinical brainstem symptoms occurred more frequently in anti-AQP4 (+) ABS patients than those in anti-AQP4 (-) ABS patients (71.43 % vs 17.65 %, p = 0.004). In examination of magnetic resonance imaging (MRI), the 78.57 % of anti-AQP4 (+) ABS patients had medulla-predominant involvements in the sagittal view and dorsal-predominant involvements in the axial view.
Conclusions: ABS represents an inaugural or limited form of NMO in a high proportion of anti-AQP4 (+) patients. |
| first_indexed | 2025-11-14T20:05:14Z |
| format | Article |
| id | nottingham-47351 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T20:05:14Z |
| publishDate | 2016 |
| publisher | BioMed Central |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-473512024-08-15T15:20:33Z https://eprints.nottingham.ac.uk/47351/ The role of anti-aquaporin 4 antibody in the conversion of acute brainstem syndrome to neuromyelitis optica Cheng, Chen Jiang, Ying Lu, Xiaodong Gu, Fu Kang, Zhuang Dai, Yongqiang Lu, Zhengqi Hu, Xueqiang Background: Acute brainstem syndrome (ABS) may herald multiple sclerosis (MS), neuromyelitis optica (NMO), or occur as an isolated syndrome. The aquaporin 4 (AQP4)-specific serum autoantibody, NMO-IgG, is a biomarker for NMO. However, the role of anti-AQP4 antibody in the conversion of ABS to NMO is unclear. Methods: Thirty-one patients with first-event ABS were divided into two groups according to the presence of anti-AQP4 antibodies, their clinical features and outcomes were retrospectively analyzed. Results: Fourteen of 31 patients (45.16 %) were seropositive for NMO-IgG. The 71.43 % of anti-AQP4 (+) ABS patients converted to NMO, while only 11.76 % of anti-AQP4 (-) ABS patients progressed to NMO. Anti-AQP4 (+) ABS patients demonstrated a higher IgG index (0.68 ± 0.43 vs 0.42 ± 0.13, p < 0.01) and Kurtzke Expanded Disability Status Scale (4.64 ± 0.93 vs 2.56 ± 0.81, p < 0.01) than anti-AQP4 (-) ABS patients. Area postrema clinical brainstem symptoms occurred more frequently in anti-AQP4 (+) ABS patients than those in anti-AQP4 (-) ABS patients (71.43 % vs 17.65 %, p = 0.004). In examination of magnetic resonance imaging (MRI), the 78.57 % of anti-AQP4 (+) ABS patients had medulla-predominant involvements in the sagittal view and dorsal-predominant involvements in the axial view. Conclusions: ABS represents an inaugural or limited form of NMO in a high proportion of anti-AQP4 (+) patients. BioMed Central 2016-10-21 Article PeerReviewed Cheng, Chen, Jiang, Ying, Lu, Xiaodong, Gu, Fu, Kang, Zhuang, Dai, Yongqiang, Lu, Zhengqi and Hu, Xueqiang (2016) The role of anti-aquaporin 4 antibody in the conversion of acute brainstem syndrome to neuromyelitis optica. BMC Neurology, 16 (1). ISSN 1471-2377 Acute brainstem syndrome; Anti-aquaporin 4 antibody; Neuromyelitis optica; Magnetic resonance imaging https://doi.org/10.1186/s12883-016-0721-1 doi:10.1186/s12883-016-0721-1 doi:10.1186/s12883-016-0721-1 |
| spellingShingle | Acute brainstem syndrome; Anti-aquaporin 4 antibody; Neuromyelitis optica; Magnetic resonance imaging Cheng, Chen Jiang, Ying Lu, Xiaodong Gu, Fu Kang, Zhuang Dai, Yongqiang Lu, Zhengqi Hu, Xueqiang The role of anti-aquaporin 4 antibody in the conversion of acute brainstem syndrome to neuromyelitis optica |
| title | The role of anti-aquaporin 4 antibody in the conversion of acute brainstem syndrome to neuromyelitis optica |
| title_full | The role of anti-aquaporin 4 antibody in the conversion of acute brainstem syndrome to neuromyelitis optica |
| title_fullStr | The role of anti-aquaporin 4 antibody in the conversion of acute brainstem syndrome to neuromyelitis optica |
| title_full_unstemmed | The role of anti-aquaporin 4 antibody in the conversion of acute brainstem syndrome to neuromyelitis optica |
| title_short | The role of anti-aquaporin 4 antibody in the conversion of acute brainstem syndrome to neuromyelitis optica |
| title_sort | role of anti-aquaporin 4 antibody in the conversion of acute brainstem syndrome to neuromyelitis optica |
| topic | Acute brainstem syndrome; Anti-aquaporin 4 antibody; Neuromyelitis optica; Magnetic resonance imaging |
| url | https://eprints.nottingham.ac.uk/47351/ https://eprints.nottingham.ac.uk/47351/ https://eprints.nottingham.ac.uk/47351/ |