Clinical features of neuromyelitis optica spectrum disorders patients with positive oligoclonal band
10.3969/j.issn.1002-0152.2025.09.001
- VernacularTitle:脑脊液寡克隆带阳性视神经脊髓炎谱系疾病患者的临床特征
- Author:
Yuxin YAO
1
;
Xiaoting LIN
;
Xianxing ZHANG
;
Wei CHEN
;
Shifang LIN
;
Zhenxin LI
;
Aiyu LIN
Author Information
1. 福建医科大学附属第一医院神经内科(福州 350002)
- Publication Type:Journal Article
- Keywords:
Neuromyelitis optica spectrum disorders;
Oligoclonal band;
Clinical feature;
Multiple core symptoms(≥3 core symptoms)co-occurrence;
Acute diencephalic clinical syndrome
- From:
Chinese Journal of Nervous and Mental Diseases
2025;51(9):513-520
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the association between cerebrospinal fluid(CSF)oligoclonal band(OCB)positivity and clinical manifestations in patients with neuromyelitis optica spectrum disorder(NMOSD).Methods A retrospective analysis of clinical data from patients with NMOSD treated at our hospital from May 2019 to January 2024 was conducted.Based on OCB test results,patients were categorized into OCB-positive and OCB-negative groups.We compared baseline characteristics between the two groups and analyzed the relationship between clinical features and OCB positivity.Results This study included a total of 62 patients,comprising 17 in the OCB+group and 45 in the OCB-group.Compared with the OCB-group,patients in the OCB+group exhibited more pronounced central nervous system inflammatory features.Specifically,OCB+group had significantly higher proportions of patients with cerebrospinal fluid white blood cell counts>8×10?/L(64.7%vs.26.7%,P=0.003)and elevated immunoglobulin indices(0.72 vs.0.61,P=0.037).Additionally,the OCB+group exhibited more complex and diverse clinical presentations.Specifically,this group showed a higher incidence of mild consciousness impairment during the acute phase(P=0.005)and a greater tendency to present with multiple core symptoms(≥3 core symptoms)occurring concurrently(52.9%vs.20.0%,P=0.025)and misdiagnosis(29.4%vs.8.9%,P=0.101).This was particularly notable when comparing to acute myelitis involving the cervical spinal cord(82.4%vs.53.3%,P=0.036)and acute diencephalic syndrome[41.2%vs.6.7%,P=0.004,including hyponatremia(35.3%vs.8.9%,P=0.033)].Multivariate logistic regression analysis demonstrated that OCB positivity(OR=3.895,95%CI:1.065-14.249)was significantly associated with the presence of multiple core symptoms.Conclusion In acute-phase NMOSD patients,OCB+is associated with significantly higher rates of co-occurrence of multiple core symptoms(≥3 core symptoms)and misdiagnosis.Notably,acute myelitis involving the cervical spinal cord and acute diencephalic clinical syndrome are particularly prevalent in this OCB+subgroup.The clinical manifestations are complex and diverse,suggesting the need for enhanced clinical identification and timely intervention.
