Value of anti-aquaporin 4 antibody in conversion of brainstem clinically isolated syndrome
10.3760/cma.j.issn.1671-8925.2016.05.008
- VernacularTitle:抗AQP4抗体对脑干临床孤立综合征转归的影响
- Author:
Chen CHENG
1
;
Ying JIANG
;
Xueqiang HU
;
Zhengqi LU
;
Wei QIU
;
Xiaobo SUN
;
Zhuang KANG
Author Information
1. 杭州师范大学附属医院神经内科
- Keywords:
Brainstem clinically isolated syndrome;
Aquaporin 4;
Neuromyelitis optica spectrum disorder;
Clinical conversion
- From:
Chinese Journal of Neuromedicine
2016;15(5):472-477
- CountryChina
- Language:Chinese
-
Abstract:
Objective Brainstem clinically isolated syndrome (BCIS) may herald multiple sclerosis (MS) or neuromyelitis (NMO),or it may occur as an isolated syndrome.However,the role of anti-aquaporin 4 antibodies in the conversion of BCIS to NMO remains uncertain.Methods Thirty-one BCIS patients hospitalized in our hospital from July 2006 to December 2010 were chosen in our study;their clinical data were retrospectively analyzed;according to the presence of anti-AQP4 antibodies,they divided into two groups:anti-AQP4(+)BCIS group (n=14) and anti-AQP4(-)BCIS group (n=l 7).The differences of clinical manifestations,imaging features and cerebrospinal fluid level between the two groups were compared and the conversion of patients from the two groups was analyzed.Results Nine (64.29％) anti-AQP4 (+)BCIS patients converted to NMO,while only two (11.76％) anti-AQP4 (-)BCIS patients progressed to NMO,over a mean follow-up period of 36.10± 18.94 months;significant difference of conversion rate was noted between the two groups (P＜0.05).Anti-AQP4(+)BCIS patients demonstrated a higher immunogamm globulin (IgG) index (0.68±0.43 vs.0.47±0.19,P=0.018) and Kurtzke Expanded Disability Status Scale (EDSS) scores at the last visit of follow-up 0.64±0.92 vs.2.71±0.81,P=0.000) than anti-AQP4 (-)BCIS patients.Gastroenterology-related brainstem symptoms occurred more frequently in anti-AQP4(+)BCIS patients than that in anti-AQP4(-)BCIS patients (71.43％ vs.23.53％,P=0.001).In brainstem MR imaging,the anti-AQP4(+)BCIS patients were observed having medulla-predominant involvement in the sagittal view (78.57％) and dorsal-predominant involvement in the axial view (78.57％),which were significantly different as compared with those in the anti-AQP4(-) BCIS patients (35.29％ and 41.17％,P＜0.05).Conclusion anti-AQP4(+)BCIS may represent an early,isolated syndrome of NMO spectrum disorder.
