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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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Autores principales: Fadda, Giulia, Flanagan, Eoin P., Cacciaguerra, Laura, Jitprapaikulsan, Jiraporn, Solla, Paolo, Zara, Pietro, Sechi, Elia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9676369/
https://www.ncbi.nlm.nih.gov/pubmed/36419536
http://dx.doi.org/10.3389/fneur.2022.1011579
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author Fadda, Giulia
Flanagan, Eoin P.
Cacciaguerra, Laura
Jitprapaikulsan, Jiraporn
Solla, Paolo
Zara, Pietro
Sechi, Elia
author_facet Fadda, Giulia
Flanagan, Eoin P.
Cacciaguerra, Laura
Jitprapaikulsan, Jiraporn
Solla, Paolo
Zara, Pietro
Sechi, Elia
author_sort Fadda, Giulia
collection PubMed
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.
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spelling pubmed-96763692022-11-22 Myelitis features and outcomes in CNS demyelinating disorders: Comparison between multiple sclerosis, MOGAD, and AQP4-IgG-positive NMOSD Fadda, Giulia Flanagan, Eoin P. Cacciaguerra, Laura Jitprapaikulsan, Jiraporn Solla, Paolo Zara, Pietro Sechi, Elia Front Neurol Neurology 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. Frontiers Media S.A. 2022-11-07 /pmc/articles/PMC9676369/ /pubmed/36419536 http://dx.doi.org/10.3389/fneur.2022.1011579 Text en Copyright © 2022 Fadda, Flanagan, Cacciaguerra, Jitprapaikulsan, Solla, Zara and Sechi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Fadda, Giulia
Flanagan, Eoin P.
Cacciaguerra, Laura
Jitprapaikulsan, Jiraporn
Solla, Paolo
Zara, Pietro
Sechi, Elia
Myelitis features and outcomes in CNS demyelinating disorders: Comparison between multiple sclerosis, MOGAD, and AQP4-IgG-positive NMOSD
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 Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9676369/
https://www.ncbi.nlm.nih.gov/pubmed/36419536
http://dx.doi.org/10.3389/fneur.2022.1011579
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