Prognostic implications of aquaporin-4 antibody status in neuromyelitis optica patients

Akman-Demir G., Tuzun E., Waters P., Icoz S., Kurtuncu M., Jarius S., ...More

JOURNAL OF NEUROLOGY, no.3, pp.464-470, 2011 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2011
  • Doi Number: 10.1007/s00415-010-5780-4
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED)
  • Page Numbers: pp.464-470
  • Keywords: Neuromyelitis optica, Multiple sclerosis, NMO-IgG, Anti aquaporin-4 antibodies, Aquaporin-4 seropositivity, Prognosis, EXTENSIVE TRANSVERSE MYELITIS, MULTIPLE-SCLEROSIS, NMO-IGG, FEATURES, MARKER, MRI
  • Istanbul University Affiliated: Yes


Neuromyelitis optica (NMO) is an inflammatory/demyelinating disorder predominantly affecting the optic nerves and spinal cord. Recent findings showed an underlying humoral abnormality in NMO, characterized by a serum antibody against aquaporin-4 (Aqp-4-Ab). In this study, we evaluated the Aqp-4-Ab status among Turkish patients with NMO to determine the clinical and prognostic relevance. Serum samples from 35 consecutive patients with NMO followed at a single center and diagnosed according to the 2006 revised criteria, were evaluated for Aqp-4-Ab. All samples were obtained during a relapse prior to any immunosuppressive treatment. Aqp-4-Ab was positive in 21/35 (60%) patients. Among these cases, 11 had an EDSS of 6.0 or more, whereas only two patients in the seronegative group had such severe disability (p < 0.05). Overall, seropositive cases had a mean EDSS score of 5.1 +/- A 2.2 compared with 3.5 +/- A 1.7 in seronegative cases (p < 0.01). There were trends towards female predominance in seropositive cases and a monophasic course predominance in seronegative cases. Disease duration, age at onset, number of attacks and time to definite NMO did not differ between groups. Our findings in this single-center cohort suggest that the presence of Aqp-4-Ab might have a prognostic significance indicating a more severe disease course.