Publications by authors named "Carolin Schwake"
Objective: In this multicentric study, we were interested in the vision-related quality of life and its association with visual impairment in neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) in comparison to multiple sclerosis (MS) and healthy controls.
Methods: We analysed extracted data from the German NEMOS registry including National Eye Institute Visual Function Questionnaire (NEI-VFQ) scores, high and low contrast visual acuity (HCVA, LCVA), visually evoked potentials (VEP) and the scores for the expanded disability status scale (EDSS) and other neurological tests which assessed their disease-related impairment. The mean follow-up time of our patients was 1.
Apheresis therapies in MOGAD: a retrospective study of 117 therapeutic interventions in 571 attacks.
J Neurol Neurosurg Psychiatry
November 2024
Background: Incomplete attack remission is the main cause of disability in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). Apheresis therapies such as plasma exchange and immunoadsorption are widely used in neuroimmunology. Data on apheresis outcomes in MOGAD attacks remain limited.
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- Cognitive impairment is a significant issue in myelin oligodendrocyte glycoprotein-IgG-associated disease (MOGAD), with a study showing that about 21.9% of patients experience cognitive deficits, particularly in mental flexibility and attention.
- The study involved 32 MOGAD patients and analyzed clinical factors like age and previous relapses, finding that the overall number of relapses and past episodes of acute disseminated encephalomyelitis (ADEM) were linked to increased cognitive impairment risk.
- MRI results indicated that patients with MOGAD had reduced white and deep gray matter volumes compared to healthy controls, highlighting potential neurological damage in this condition.
Background: Data on cognition in patients with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are limited to studies with small sample sizes. Therefore, we aimed to analyse the extent, characteristics and the longitudinal course of potential cognitive deficits in patients with MOGAD.
Methods: The CogniMOG-Study is a prospective, longitudinal and multicentre observational study of 113 patients with MOGAD.
Epstein-Barr virus (EBV) infection has long been associated with the development of multiple sclerosis (MS). MS patients have elevated titers of EBV-specific antibodies in serum and show signs of CNS damage only after EBV infection. Regarding CD8+ T-cells, an elevated but ineffective response to EBV was suggested in MS patients, who present with a broader MHC-I-restricted EBV-specific T-cell receptor beta chain (TRB) repertoire compared to controls.
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- The study examines the impact of anti-CD20 monoclonal antibodies (mAbs) on B-cell counts in infants born to mothers who were exposed to these medications ≤6 months before or during pregnancy and lactation.
- A total of 49 infants were analyzed, showing that CD19 B-cell counts in most cases were comparable to healthy reference values, with only minimal occurrences of complete B-cell depletion following certain timings of maternal exposure.
- The findings suggest that using anti-CD20 mAbs around pregnancy is generally safe, although some monitoring may be necessary for infants exposed during the second or third trimester due to potential B-cell depletion.
Article Synopsis
- The study focused on understanding how disability accumulates in patients with neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein-antibody-associated disease (MOGAD), examining factors like disease duration, attack frequency, and age.* -
- Data from 483 patients indicated that NMOSD patients reached significant disability milestones much sooner than MOGAD patients, despite similar attack rates; older age at symptom onset was linked to higher disability risk.* -
- Overall, NMOSD and MOGAD exhibit different patterns of disability progression, with MOGAD being less severe, and recent research has enhanced awareness and treatment strategies, positively impacting patient outcomes.*
Importance: Differential diagnosis of patients with seronegative demyelinating central nervous system (CNS) disease is challenging. In this regard, evidence suggests that immunoglobulin (Ig) A plays a role in the pathogenesis of different autoimmune diseases. Yet little is known about the presence and clinical relevance of IgA antibodies against myelin oligodendrocyte glycoprotein (MOG) in CNS demyelination.
View Article and Find Full Text PDFInpatient care of neuromyelitis optica spectrum disorder in Germany: Nationwide analysis from 2010 to 2021.
Mult Scler J Exp Transl Clin
July 2023
Article Synopsis
- The study investigates inpatient cases and immunotherapies for neuromyelitis optica spectrum disorder (NMOSD) in Germany over the last decade.
- Results show a significant increase in hospitalized NMOSD patients from 463 in 2010 to 992 in 2021, with an average patient age of around 48 years, predominantly female.
- The use of apheresis treatments has decreased as more effective immunotherapies, like rituximab, have been administered, indicating better disease management and awareness without seasonal relapse spikes.
Background: There is limited and inconsistent information on the prevalence of cognitive impairment in neuromyelitis optica spectrum disorders (NMOSD).
Objective: To assess cognitive performance and changes over time in NMOSD.
Methods: This study included data from 217 aquaporin-4-IgG-seropositive (80%) and double-seronegative NMOSD patients.
Background: Data on the humoral vaccine response in patients on anti-interleukin-6 (IL-6) receptor therapy remain scarce.
Objective: The main objective of our study was to investigate the humoral response after vaccination against SARS-CoV-2 in neuromyelitis optica spectrum disorder (NMOSD)/myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) patients treated with anti-IL-6 receptor therapy. Secondarily, we analyzed relapse activity timely associated with vaccination.
Article Synopsis
- The study investigates the significance of myelin oligodendrocyte glycoprotein antibody positivity in cerebrospinal fluid (CSF) for diagnosing MOG antibody-associated disease (MOGAD), analyzing data from 11 medical centers.
- A total of 255 patients were evaluated, with 56.8% showing MOG-Abs in both serum and CSF, while others had MOG-Abs present in either serum or CSF only.
- Results indicated that patients with MOG-Abs positive in both serum and CSF experienced worse disability and more frequent motor, sensory, and sphincter symptoms compared to those with only serum positivity.
Article Synopsis
- Recent studies have identified inflammatory neuropathies that involve the nodes of Ranvier and are caused by specific autoantibodies, particularly anti-pan-NF-associated neuropathies, which are rare and can be life-threatening.
- A case of a 52-year-old male with this condition showed rapid progression to a severe "locked-in" syndrome, despite initial treatment, and was characterized by specific antibody presence and non-excitable nerves.
- A combination of aggressive immunotherapy, including rituximab and bortezomib, led to significant clinical improvement and normalization of nerve function over three months, suggesting this combination may be an effective treatment for these rare neuropathies.*
Article Synopsis
- The study aimed to compare the severity and recovery of optic neuritis associated with myelin oligodendrocyte glycoprotein (MOG) antibodies in pediatric versus adult patients.
- It included 20 pediatric and 39 adult MOGAD patients, examining retinal thickness and visual function after at least 6 months post-onset of optic neuritis.
- Results indicated that children had significantly better visual acuity and recovery compared to adults, despite similar levels of retinal damage, suggesting age plays a crucial role in recovery outcomes.
Article Synopsis
- B-cell depletion using anti-CD20 antibodies is a common treatment for multiple sclerosis (MS), but there is limited understanding of the infection risks tied to this long-term therapy.
- A case is presented of a 45-year-old man who developed severe pneumonia after six years of rituximab treatment for highly active relapsing-remitting MS, despite having no significant pre-existing health issues.
- The patient ultimately recovered after a course of antibiotics, highlighting the serious infection risks associated with prolonged B-cell depletion and emphasizing the need for increased awareness in managing such patients.
Endocarditis following ocrelizumab in relapsing-remitting MS.
Neurol Neuroimmunol Neuroinflamm
May 2020