Publications by authors named "Lotan I"
Clinical Characterization and Prognostic Risk Factors of Susac Syndrome: A Retrospective Multicenter Study.
Neurol Neuroimmunol Neuroinflamm
March 2025
Background And Objectives: Susac syndrome (SuS) is a rare disorder characterized by encephalopathy, branch retinal artery occlusion, and sensorineural hearing loss, often accompanied by vertigo. Recent updates to diagnostic criteria and treatment guidelines have been made. This study examines clinical manifestations; disease activity; and risk factors of disability, dependency, and return to work in patients with SuS.
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- Patients with neuromyelitis optica spectrum disorder (NMOSD) often have antibodies against aquaporin-4 (AQP4), making MRI monitoring critical for understanding the disease's progression.
- A retrospective study involved MRI data from 525 AQP4-IgG-seropositive NMOSD patients across 11 countries, focusing on the types and locations of lesions in the central nervous system.
- Results showed a high prevalence of hyperintense lesions in the brain and significant patterns of myelitis in the spinal cord, emphasizing the importance of MRI in tracking this condition.
Article Synopsis
- The study applied the 2022 international consensus criteria for optic neuritis (ICON) to 160 patients with acute optic neuritis to assess its effectiveness in classification.
- About 50% of the patients were classified as definite optic neuritis, while 43% were not classified as having ON, mainly due to the absence of critical symptoms like relative afferent pupillary defect (RAPD) and dyschromatopsia.
- The adjusted criteria led to a higher classification of 79% of patients as having optic neuritis, highlighting the importance of thorough examinations for accurate diagnosis.*
Background: Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a rare autoimmune demyelinating disorder of the central nervous system. Optic neuritis (ON) is the most common clinical manifestation of MOGAD in adults. In 2023, new MOGAD diagnostic criteria were proposed, highlighting the importance of supplemental criteria when MOG-immunoglobulin G (IgG) titers are unavailable.
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- This study investigates how comorbidities, especially vascular ones, affect patients with multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and MOG-antibody-associated disease (MOGAD), potentially worsening their neurological condition.* -
- The proposed study, called COMMIT, will involve a diverse group of patients and will analyze various biological markers related to inflammation and neurodegeneration using advanced technologies and data analysis methods.* -
- The ultimate aim is to understand the influence of comorbidities on the clinical outcomes of these CNS diseases, potentially leading to better treatment strategies for improving patient health and quality of life.*
Background: Detection of oligoclonal bands (OCBs) in the cerebrospinal fluid (CSF) is important for diagnosis of multiple sclerosis (MS). Previous studies reported that treatment with intravenous methylprednisolone (IVMP) before lumber puncture (LP) could suppress OCBs production. The aim of this study was to assess whether IVMP initiation prior to CSF collection affects OCBs results in patients with an acute demyelinating event.
View Article and Find Full Text PDFBackground: Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an autoimmune disease that can present as a monophasic or relapsing disease course. Here, we investigate the predictors of developing relapsing disease with a focus on the index event.
Methods: MOGAD patients followed at Massachusetts General Hospital and Brigham and Women's Hospital were included.
Proinflammatory cytokines, such as (IL: interleukin) IL-6 and IL-17A, and complement fixation are critical in the immunopathogenesis of neuromyelitis optica spectrum disorders (NMOSD). Blocking the IL-6 receptor or the C5 complement pathway reduces relapse risk. However, the role of interleukin (IL)-6 and complement in aquaporin-4 (AQP4) autoimmunity remains unclear.
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- Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) can lead to neurological issues like optic neuritis and transverse myelitis, with various treatment options being used for relapsing cases.
- A study reviewed the effectiveness of different treatments (steroids, B-cell depletion, IVIG, and mycophenolate mofetil) on annualized relapse rates (ARRs) and relapse-freedom in 88 patients with MOGAD.
- Results showed that IVIG had the best outcomes with the lowest ARRs and highest chance of relapse-freedom, while B-cell depletion showed the least effectiveness, particularly in pediatric patients where mycophenolate mofetil was most effective.
Acute optic neuritis treatment lacks standardized protocols. The value of oral prednisone taper (OPT) following intravenous methylprednisolone (IVMP) on visual outcome parameters in optic neuritis (ON) has never been explored. In the present retrospective study, we investigated whether OPT after IVMP affects the structural and functional visual outcomes of inaugural clinically isolated syndrome (CIS)- or multiple sclerosis (MS)-ON.
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- A study investigated the effectiveness of intravenous immunoglobulins (IVIGs) for treating acute myelin oligodendrocyte glycoprotein antibody disease (MOGAD) attacks.
- The research involved analyzing data from 39 patients across seven neuroimmunology centers, focusing on patient demographics and symptoms before and after IVIG treatment.
- Results showed significant improvements in disability and visual acuity following IVIG administration, suggesting it may be a beneficial treatment for MOGAD, although further studies are needed to confirm these findings.
Experimental autoimmune encephalomyelitis (EAE) is an animal model of Inflammatory central nervous system (CNS) disease. Dark agouti (DA) rats immunized with full-length myelin oligodendrocyte glycoprotein (MOG) typically develop a relapsing-remitting EAE form characterized by predominant demyelinating involvement of the spinal cord and optic nerve. Visually evoked potentials (VEP) are a useful objective tool to assess the optic nerve function and monitor electrophysiological changes in optic neuritis (ON).
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- Optic neuritis (ON) often signals the onset of multiple sclerosis (MS) and other related disorders, with high-dose corticosteroids recommended for treatment but not adequately studied regarding timing and patient antibodies.
- The Acute Optic Neuritis Network (ACON) aims to investigate how the timing of corticosteroid treatment affects visual outcomes 6 months post-ON onset by enrolling patients who present within 30 days of initial symptoms.
- The study will collect extensive data on various ON subtypes and factors like visual acuity, imaging results, and patient-reported outcomes from 28 hospitals globally, targeting a recruitment of 200 patients across different ON classifications.
Article Synopsis
- * In a large cohort of patients, none died, leading to an estimated upper limit of a 95% confidence interval showing a crude mortality rate of 2.1%.
- * The findings suggest that MOGAD mortality is lower than in other neuroinflammatory diseases and similar to age-adjusted mortality rates in the general U.S. population, but further research is needed to confirm these results.
Purpose: To evaluate the effectiveness of plasma exchange (PLEX) for optic neuritis (ON).
Methods: We conducted an international multicenter retrospective study evaluating the outcomes of ON following PLEX. Outcomes were compared to raw data from the Optic Neuritis Treatment Trial (ONTT) using a matched subset.
Volumetric brain changes in MOGAD: A cross-sectional and longitudinal comparative analysis.
Mult Scler Relat Disord
January 2023
Background: Relatively little is known about how global and regional brain volumes changes in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) compare with Multiple Sclerosis (MS), Neuromyelitis optica spectrum disorder (NMOSD), and healthy controls (HC).
Objective: To compare global and regional brain volumes in MOGAD, MS, NMOSD, and HC cross-sectionally as well as longitudinally in a subset of patients.
Methods: We retrospectively reviewed all adult MOGAD and NMOSD patients with brain MRI performed in stable remission and compared them with MS patients and HC.
Background And Objectives: Inhibition of terminal complement in neuromyelitis optica spectrum disorder (NMOSD) using eculizumab helps prevent relapses, but the exact mechanism of action of the drug remains unclear. Similarly, genetic variants in the Fc Gamma receptor 3A (FCGR3A), also known as CD16, are correlated with outcomes in NMOSD, but the immune cells expressing those CD16 are unknown. We compared CD16 expression on immune cells modulated by complement activity in natural killer (NK) cells and natural killer-T (NKT) cells in NMOSD to disease and normal-healthy controls.
View Article and Find Full Text PDFOptic neuritis (ON) is a frequent presentation at onset of multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). The pathophysiology underlying these diseases, especially MOGAD, is still being elucidated. While obesity has been reported to potentially be a risk factor for MS, this has not been explored in NMOSD or MOGAD.
View Article and Find Full Text PDFBackground: Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) has various similarities with AQP4-IgG-seropositive Neuromyelitis Optica Spectrum Disorder (AQP4-IgG + NMOSD) in terms of clinical presentations, magnetic resonance imaging (MRI) findings, and response to treatment. But unlike AQP4-IgG + NMOSD, which is known to coexist with various autoimmune diseases and cancers, an association of MOGAD with these conditions is less clear.
Methods: We conducted a systematic search in PubMed, Scopus, Web of Science, and Embase based on the preferred reporting items for systematic reviews and meta-analysis (PRISMA).
Objectives: Elevated lumbar puncture opening pressure (ELPOP) is a reported but understudied phenomenon in aseptic meningitis. This study aimed to characterize the features of ELPOP in aseptic meningitis patients.
Methods: An observational, retrospective, single-center study was conducted.
Details and outcomes of a large cohort of MOG-IgG associated optic neuritis.
Mult Scler Relat Disord
December 2022
Article Synopsis
- The study aimed to explore the timing of eye pain and visual loss in patients with optic neuritis associated with MOG-IgG and assess how early steroid treatment impacts recovery.
- Researchers reviewed data from 107 patients and found that eye pain often occurred before vision loss, with those receiving early steroid treatment recovering faster and achieving better visual outcomes.
- However, recovery without steroids was noted in some cases, indicating that further research through randomized clinical trials is necessary to confirm these findings.
Background: Viral infections are a proposed possible cause of inflammatory central nervous system (CNS) demyelinating diseases, including multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). During the past 2 years, CNS demyelinating events associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been reported, but causality is unclear.
Objective: To investigate the relationship between CNS demyelinating disease development and exacerbation with antecedent and/or concurrent SARS-CoV-2 infection.
New Treatment Perspectives for Acute Relapses in Neuromyelitis Optica Spectrum Disorder.
Transfus Med Rev
October 2022
Neuromyelitis optica spectrum disorder (NMOSD) is a chronic autoimmune disease of the central nervous system, characterized by recurrent attacks of optic neuritis, transverse myelitis, brainstem, and/ or cerebral symptoms. Despite the current standard of care consisting of high-dose corticosteroids and therapeutic plasma exchange, many patients are left with a permanent neurological disability after each attack. With the recent advancements in understanding the pathogenic mechanisms involved in NMOSD relapses, possibilities to develop new targeted therapies are anticipated.
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