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Myelin-oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a recently identified autoimmune disorder that presents in both adults and children as CNS demyelination. Although there are clinical phenotypic overlaps between MOGAD, multiple sclerosis, and aquaporin-4 antibody-associated neuromyelitis optica spectrum disorder (NMOSD) cumulative biological, clinical, and pathological evidence discriminates between these conditions. Patients should not be diagnosed with multiple sclerosis or NMOSD if they have anti-MOG antibodies in their serum. However, many questions related to the clinical characterisation of MOGAD and pathogenetic role of MOG antibodies are still unanswered. Furthermore, therapy is mainly based on standard protocols for aquaporin-4 antibody-associated NMOSD and multiple sclerosis, and more evidence is needed regarding how and when to treat patients with MOGAD.

Objective Our primary objective was to examine the neuropsychological and psychopathological profile of patients with neuromyelitis optica (NMO) and compare these to multiple sclerosis (MS) and healthy control (HC) groups. We also examined for relationships between cognitive and psychiatric variables and clinical factors including accumulated neurological disability and disease duration. Methods A neuropsychological test battery was administered along with a structured psychiatric interview and quantitative measures of mood symptoms. Results 42 NMO, 42 MS and 42 HC participants were assessed. Cognitive impairments were observed in 67% of NMO patients. The prevalence and profile of cognitive impairments and lifetime prevalence of depression was similar between NMO and MS groups. However, significantly higher rates of recurrent depression and suicidality were observed in NMO patients. Correlational analyses revealed higher levels of anxiety symptoms were associated with shorter disease duration in NMO, while higher depression symptom levels were associated with higher neurological disability and poorer cognition. Conclusions Our results demonstrate substantial cognitive and psychiatric comorbidities in NMO patients. Similar rates of lifetime and current depression between NMO and MS appear to mask greater underlying psychiatric burden in NMO and further understandings of the course of neurobehavioural comorbidities is required to better comprehend the additional morbidity in NMO. Our data support a role for cognitive and psychiatric assessments in the comprehensive care of NMO patients.

Nanocrystalline Titanium dioxide particles have been synthesized through hydrothermal method to study the effect of autoclaving temperature and annealing temperature on their particulate characteristics. The nanoparticles have been synthesized using a Titanium alkoxide precursor at two different temperatures 160 °C and 200 °C for 14h and annealed at 450 °C. X-ray diffraction studies were used to ascertain the tetragonal structure and the anatase phase represented by the synthesized samples. The particle size of the synthesized material was derived using the Scherrer formula and it was found to be of the order of 10 - 20 nm. The optical absorption spectrum reveals the absorption-edge to be slightly red-shifted. The band gap of the synthesized materials was evaluated using the Tauc plot and it was determined to be ∼ 3.25 ± 0.02eV. The emission spectrum for the sample was recorded at an excitation wavelength of 295 nm and the flat bands were found to depict the inherent defect states. Although the FE-SEM images display a high agglomeration, they reveal the morphology of the particulates to be a spherical one. The HR-TEM images of the sample clearly corroborate with the spherical morphology and the particle size as represented by FESEM and XRD studies respectively.

Background Transverse myelitis (TM) associated with Neuromyelitis Optica (NMO) can be severe and is well known to reduce mobility early in the disease. However the burden of bladder and bowel dysfunction is unknown and overlooked. We studied the frequency of bladder and bowel dysfunction and their impact on quality of life. Methods A cross-sectional study of 60 patients who had AQP4-IgG positive NMO associated TM was performed using the Bladder Control Scale, Lower Urinary Tract Quality of Life, Bowel Control Scale and Neurogenic Bowel Score, Short-Form-36 Health Survey and EDSS. The relationships between the variables were analysed with multiple linear regression. Results Fifty women and 10 men participated. 78% (47/60) patients reported bladder symptoms and a similar number reported bowel problems. 87% (52/60) patients reported either bladder or bowel dysfunction. 65% (39/60) developed residual symptoms after the first episode of myelitis and the remaining by the second episode. Both bladder and bowel dysfunction reduced quality of life and required modification of lifestyle in 83% (39/47) and 70% (33/47) respectively. Conclusion Bladder and bowel dysfunction is very common in NMO associated myelitis developing early in the disease and significantly affects quality of life.

Background Seasonal variation in incidence and exacerbations has been reported for neuroinflammatory conditions such as multiple sclerosis and acute disseminated encephalomyelitis (ADEM). It is unknown whether seasonality also influences aquaporin-4 antibody (AQP4-Ab) disease and myelin-oligodendrocyte antibody (MOG-Ab) disease. Objective We examined the seasonal distribution of attacks in AQP4-Ab disease and MOG-Ab disease. Methods Observational study using data prospectively recorded from three cohorts in the United Kingdom. Results There was no clear seasonal variation in AQP4-Ab or MOG-Ab attacks for either the onset attack nor subsequent relapses. In both groups, the proportion of attacks manifesting with each of the main phenotypes (optic neuritis, transverse myelitis, ADEM/ADEM-like) appeared stable across the year. This study is the first to examine seasonal distribution of MOG-Ab attacks and the largest in AQP4-Ab disease so far. Conclusion Lack of seasonal distribution in AQP4-Ab and MOG-Ab disease may argue against environment factors playing a role in the aetiopathogenesis of these conditions.

Population-based screening studies suggest an overall prevalence of coeliac disease in Western populations of about 1%. A variety of neurological problems have been associated with coeliac disease occurring in up to 10% of cases of adult coeliac disease. We report an interesting case of a patient with coeliac disease who subsequently developed neurological symptoms several years later. Furthermore, a literature review of all cases to date was performed.

Natalizumab, an effective treatment for MS, has been shown to exacerbate neuromyelitis optica (NMO) with aquaporin-4 antibodies, but whether this is the case in antibody negative NMO and atypical MS/NMO spectrum disorder overlap syndromes is unknown. We describe a patient with a relapsing optico-spinal demyelinating syndrome, negative for aquaporin-4 antibodies, who experienced a catastrophic brain relapse shortly after a single dose of natalizumab, highlighting that MS immunomodulatory drugs may worsen demyelination in patients with seronegative NMO and atypical MS/NMO overlap syndromes even if they are aquaporin-4 antibody negative. We summarise the treatments considered safe and effective in NMO, and those with potential to exacerbate disease. © 2014 Elsevier B.V.

Neuromyelitis optica (NMO; Devic's disease) and the NMO spectrum disorders are idiopathic inflammatory demyelinating disorders that affect the central nervous system and have a predilection for optic nerves and spinal cord. The identification of NMO-IgG as a disease-specific marker and aquaporin 4 as the target antigen has renewed interest in NMO. Based on current data, we suspect that autoantibodies arising from peripheral B cells bind to aquaporin 4 expressed on astrocyte foot processes on the abluminal surface of microvessels, activate complement and initiate inflammatory demyelination and necrosis. The development of animal models and further analysis of the association of NMO-IgG with disease severity and treatment response will elucidate the pathobiology of NMO.

Introduction Le tabagisme, l’un des principaux facteurs environnementaux, intervient dans de nombreuses pathologies et sur le systeme immunitaire, mais sont role dans la neuromyelite optique (NMO) est actuellement mal connu. Objectifs Evaluer l’impact du tabagisme sur la progression et la gravite de la maladie dans une cohorte de patients atteints de neuromyelite optique. Methodes Etude multicentrique realisees dans quatre centres (Strasbourg, France ; Vejle, Danemark ; Baltimore, Etats-Unis et de Liverpool, Royaume-Uni) sur 139 patients atteints de NMO selon les criteres de Wingerchuk 2006. Nous avons recueilli les donnees concernant les habitudes des patients vis-a-vis du tabagisme (nombre de paquet/annee (P/A), duree du tabagisme) a l’aide d’un questionnaire standardise, lors d’une hospitalisation, d’une consultation ou par telephone. Les patients ont ete divises en 3 groupes (non-fumeurs, anciens fumeurs, fumeurs actifs). Resultats Soixante-quatorze (53,2 %) non-fumeurs, 35 (25,2 %) anciens fumeurs et 30 (21,6 %) fumeurs actifs ont ete inclus. Le nombre de poussees etait significativement plus elevee chez les fumeurs actifs que dans les deux autres groupes (p Discussion Il s’agit de la premiere etude evaluant l’impact de la consommation de tabac dans NMO, et nos resultats suggerent que dans notre population de patients avec NMO, le tabagisme est defavorable sur la progression et la gravite de la maladie, comme cela a ete demontre dans d’autres maladies auto-immunes et en particulier la sclerose en plaques. Les mecanismes physiopathologiques sont mal connus et multiples. Conclusion Le tabagisme semble etre un facteur de progression et de severite de la maladie dans la NMO. Une incitation au sevrage tabagique chez les patients pourrait etre benefique.