Preliminary findings of a 'test bundle' to accelerate the diagnosis of MS and NMOSD following optic neuritis.

Autor: Avasarala J; Department of Neurology, University of Kentucky Medical Center, 740 S Limestone, Lexington, KY 40536, United States. Electronic address: javasarala@uky.edu., McLouth C; Department of Biostatistics, University of Kentucky College of Public Health, 725 Rose St, Lexington, KY 40536, United States., Khawla A; Staff Neuro-ophthalmologist and Neurologist, Newton Medical Center, 600 Medical Center Dr., KS 67114, United States., Wilkerson P; Department of Neurology, University of Kentucky Medical Center, 740 S Limestone, Lexington, KY 40536, United States., Anderson-Benge E; American Academy of Neurology, 201 Chicago Ave., Minneapolis, MN 55415, United States., Lundgren KB; American Academy of Neurology, 201 Chicago Ave., Minneapolis, MN 55415, United States., Das S; Department of Neurology, University of Kentucky Medical Center, 740 S Limestone, Lexington, KY 40536, United States.
Jazyk: angličtina
Zdroj: Multiple sclerosis and related disorders [Mult Scler Relat Disord] 2024 Nov; Vol. 91, pp. 105890. Date of Electronic Publication: 2024 Sep 19.
DOI: 10.1016/j.msard.2024.105890
Abstrakt: No study has investigated the length of time it takes to diagnose multiple sclerosis (MS) or neuromyelitis optic spectrum disorder (NMOSD, aquaporin 4 antibody disease or myelin oligodendrocyte glycoprotein antibody disease, MOGAD) following the onset of de novo optic neuritis (ON). Minimizing the time between ON and downstream diagnoses needs urgency since early diagnosis equals early treatment. The time elapsed from ON to a subsequent diagnosis of MS/NMOSD was estimated through analysis of retrospective data collected from the Axon Registry (AR) of the American Academy of Neurology (AAN) and from the University of Kentucky (UK), Lexington. The time to diagnose MS/NMOSD was arbitrarily set as occurring < 6 months (early) or > 6 months (delayed) following ON. Data was collected between 2007 and 2021 (AR) and 2012 to 2022, for UK, respectively. Of the 4015 ON patients from the AR dataset, 1069 (26.6 %) were diagnosed with MS, with 857 (80.2 %) diagnosed < 6 months (early) and 212 (19.8 %) diagnosed after > 6 months (delayed). Secondly, 420/4015 (10.4 %) were diagnosed with NMOSD (either MOGAD or AQP4 antibody disease), of which 340/420 (80.9 %) were diagnosed < 6 months (early) and 80/420 (19 %) diagnosed > 6 months (delayed). In the UK dataset, a total of 90/1464 individuals (6.14 %) were diagnosed with MS; of these, 69 patients (76.7 %) were diagnosed at < 6 months (early) and included a sub-group of 25 (27.8 %) diagnosed < 4 weeks; 21 (23.3 %) were diagnosed > 6 months (delayed) following ON. In either dataset (AR or UK, between 20 % - 23 % of MS diagnoses occurred > 6 months (delayed) after a diagnosis of ON. An accelerated diagnosis (4 weeks or less) of MS/NMOSD following ON in the UK data suggests that it is possible to minimize the time to a downstream diagnosis if a 'test bundle' of MRI of orbits, brain, C-spine, cerebrospinal fluid (CSF) analysis, and serum testing for NMOSD is used. Additional studies using prospective, larger datasets are required to confirm our findings.
Competing Interests: Declaration of competing interest The authors declare no conflict of interest.
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
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