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Publications

Journal Article Ppublish

PubMed: 42798289 DOI: 10.1111/ene.70767

Serum GFAP and Age Accurately Distinguish AQP4-IgG Positive and Double Seronegative NMOSD From MOGAD After a Recent Attack.

Eur J Neurol 33(10):e70767

Authors: Manon Rival, Fabien Rollot, Sabine Laurent-Chabalier, Romain Casey, Illiasse El Bahi, Guillaume Brocard, Romain Marignier, Sophie Trouillet-Assant, Sandra Vukusic, Agnès Fromont, David Axel Laplaud, Guillaume Mathey, Elisabeth Maillart, Laure Michel, Aurélie Ruet, Pierre Labauge, Xavier Ayrignac, Hélène Zephir, Jonathan Ciron, Jérôme de Sèze, Arnaud Kwiatkowski, Caroline Papeix, Pierre Branger, Christine Lebrun-Frenay, Eric Berger, Pierre Clavelou, Olivier Heinzlef, Jean Pelletier, Abdullatif Al-Khedr, Olivier Casez, Bertrand Bourre, Alain Créange, Thomas David, Laurent Magy, Jean-Philippe Camdessanche, Inès Doghri, Amélie Dos Santos, Thibault Mura, Hanane Agherbi, Eric Thouvenot

Affiliations

  • IGF, Univ Montpellier, CNRS, Inserm, Montpellier, France.
  • Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.
  • Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Hospices Civils de Lyon, Bron, France.
  • INSERM 1028 et CNRS UMR 5292, Centre de Recherche en Neurosciences de Lyon, Observatoire Français de la Sclérose en Plaques, Lyon, France.
  • EUGENE DEVIC EDMUS Foundation Against Multiple Sclerosis, State-Approved Foundation, Bron, France.
  • Laboratoire de Biostatistique, Epidémiologie Clinique, Santé Publique Innovation et Méthodologie (BESPIM), CHU Nimes, Univ Montpellier, Nimes, France.
  • Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (MIRCEM)-Hôpital Neurologique Pierre Wertheimer Hospices Civils de Lyon, Lyon, France.
  • International Center of Research in Infectiology, INSERM U1111, CNRS UMR 5308, ENS, UCBL, Lyon University, Lyon, France.
  • Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France.
  • Department of Neurology, CHU de Dijon, Dijon, France.
  • Service de Neurologie, INSERM, Center for Research in Transplantation and Translational Immunology, UMR 1064, CIC INSERM 1413, CRC-SEP Pays de la Loire, CHU Nantes, Nantes Université, Nantes, France.
  • Department of Neurology, Nancy University Hospital, Nancy, France.
  • Université de Lorraine, Nancy, France.
  • Département de Neurologie, APHP, Hôpital Pitié-Salpêtrière, Paris, France.
  • Centre de Reference des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Paris, France.
  • Neurology Department, Clinical Neuroscience Centre, CIC_P1414 INSERM, MOBIDIC_U1236, University Hospital, Rennes University, Rennes, France.
  • Department of Neurology, MS Center, University Hospital of Bordeaux, Bordeaux, France.
  • Neurocentre Magendie, INSERM U1215, Bordeaux University, Bordeaux, France.
  • MS Unit, CHU de Montpellier, Montpellier Cedex 5, France.
  • University of Montpellier (MUSE), Montpellier, France.
  • INM, INSERM, Département de Neurologie, CRC Sclérose en Plaques, CRMR LEUKOFRANCE & Centre d'Investigation Clinique U1411, CHU de Montpellier, Univ Montpellier, Montpellier, France.
  • CHU Lille, CRCSEP Lille, Univ Lille, Lille, France.
  • Department of Neurology, CHU de Toulouse, CRC-SEP, Toulouse Cedex 9, France.
  • Infinity, INSERM UMR1291-CNRS UMR5051, Université Toulouse III, Toulouse Cedex 3, France.
  • Department of Neurology and Clinical Investigation Center, CIC 1434, INSERM 1434, CHU de Strasbourg, Strasbourg, France.
  • Department of Neurology, Groupement des Hôpitaux de l'Institut Catholique de Lille, Hôpital Saint Vincent de Paul, Lille, France.
  • Department of Neurology, Foundation Adolphe de Rothschild Hospital, Paris, France.
  • Université Paris-Cité, Paris, France.
  • Department of Neurology, CHU de Caen, MS Expert Centre, Normandy University, Caen, France.
  • Neurology, UR2CA_URRIS, Centre Hospitalier Universitaire Pasteur2, Université Nice Côte d'Azur, Nice, France.
  • Service de Neurologie, CHU de Besançon, Besançon, France.
  • Department of Neurology, INSERM NeuroDol U1107, CHU Clermont-Ferrand, CRC SEP Auvergne, Clermont-Ferrand, France.
  • Department of Neurology, CRC Sclérose en Plaques IDF Ouest, Hôpital de Poissy, Poissy, France.
  • Service de Neurologie, Pôle de Neurosciences Cliniques, APHM, Hôpital de la Timone, Aix Marseille Univ, Marseille, France.
  • Department of Neurology, CHU d'Amiens, Amiens, France.
  • Department of Neurology, Neurology MS Clinic Grenoble, Grenoble Alpes University Hospital, CHU Grenoble Alpes, Grenoble, France.
  • T-RAIG, TIMC-IMAG, Grenoble Alpes University, Grenoble, France.
  • Department of Neurology, CHU de Rouen, Rouen, France.
  • Department of Neurology, APHP, Hôpital Henri Mondor, Créteil, France.
  • Department of Neurology, CHU de la Martinique, Fort-de-France, France.
  • Department of Neurology, CHU de Limoges, Hôpital Dupuytren, Limoges, France.
  • Department of Neurology, CHU de Saint-Étienne, Hôpital Nord, Saint-Étienne, France.
  • CRC SEP, Department of Neurology, CHU de Tours, Hôpital Bretonneau, Tours, France.
  • Department of Neurology et Centre d'Investigation Clinique, CIC INSERM 1402, CHU La Milétrie, Hôpital Jean Bernard, Poitiers, France.
  • Service de Neurologie, CHU Nimes, Univ Montpellier, Nimes, France.

Abstract

BACKGROUND

Serum neurofilament-light chain (sNfL) and glial fibrillary acidic protein (sGFAP) are associated with multiple sclerosis (MS) activity. This study aimed to identify patient- and disease-level determinants of sNfL and sGFAP and to evaluate their ability to support differential diagnosis in neuromyelitis optica (NMO).

METHODS

sNFL and sGFAP levels were measured in 640 patients from the OFSEP cohort (88 NMO spectrum disorder (NMOSD) with anti-aquaporin-4 antibodies [AQP4-NMOSD], 28 double-seronegative NMOSD [DN-NMOSD], 61 myelin oligodendrocyte glycoprotein antibody-associated disease [MOGAD], 64 clinically isolated syndrome [CIS], 237 relapsing-remitting MS [RRMS], and 162 primary progressive MS [PPMS]). The association between log[sNFL] and log[sGFAP] and age, sex, time since relapse, EDSS, oligoclonal bands, and MRI characteristics was analyzed by multiple linear regression. The diagnostic performance of sNfL and sGFAP in discriminating between NMOSD and MS subgroups was evaluated using multivariable logistic regression and area under the curve (AUC).

RESULTS

For each group, specific associations of sNFL and sGFAP levels with patient characteristics were observed. Clearest associations were observed in AQP4-NMOSD patients. After a recent attack (≤ 90 days), multivariate analysis revealed that sGFAP and age discriminated AQP4-NMOSD from MOGAD (AUC = 0.939 [0.910;0.982]), AQP4-NMOSD and DN-NMOSD from MOGAD (AUC = 0.863 [0.776;0.977]), and AQP4-NMOSD from all other groups (AUC = 0.950 [0.918;0.987]). Diagnostic probability heatmaps based on sGFAP and age illustrate the probability of each diagnosis relative to others for bedside interpretation.

CONCLUSION

After an acute attack of NMOSD, risk score based on sGFAP and age may guide the management of patients before autoantibody status is available.

MeSH

Multiple Sclerosis, Serum, Probability, Biomarkers, Neuromyelitis Optica, Diagnosis, Nervous System Diseases