Mayo Clinic Laboratories > Neurology > CNS demyelinating disease

CNS demyelinating disease

Cutting-edge investigations to differentiate disease

Immune-mediated central nervous system (CNS) disorders, including neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein (MOG-IgG) associated disease (MOGAD), present with similar clinical and radiologic features as multiple sclerosis, which is the most common CNS demyelinating disease. Because multiple sclerosis treatment may worsen NMOSD and MOGAD, accurate diagnosis is critical.

90%

90% of patients with NMOSD are initially misdiagnosed with multiple sclerosis1

1/3

1/3 of AQP4-IgG-negative patients are positive for MOG-IgG2

50%

50% probability of second optic neuritis episode within one year of initial attack in AQP4-positive patients3

CNS demyelinating disease Test menu

CNS demyelinating disease CNS demyelinating disease

CNS demyelinating disease

Our unique evaluation to diagnose immune-mediated CNS demyelinating disease uses a fluorescence activated cell sorting (FACS) live cell-binding assay to detect the two most common antibodies linked to the harmful autoimmune response. Identification of aquaporin-4 (AQP4-IgG) and MOG-IgG allows for diagnostic certainty and implementation of an appropriate treatment regimen, which minimizes the risk of relapse and patient disability.

Key testing

Advantages

  • Uses innovative FACS technology for improved detection of AQP4-IgG and MOG-IgG antibodies.
  • Yields 76.7% sensitivity, compared to 60% sensitivity through ELISA.
  • Enables 100% specificity for AQP4.
  • Allows for a faster diagnosis and treatment plan decision for your patient.
View chart We recommend testing for AQP4-IgG and MOG-IgG at the same time. This synchronized testing method allows for a faster diagnosis and treatment plan decision for your patient.

Highlights

Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD)

In this month's "Hot Topic," Eoin Flanagan, M.B., B.Ch., reviews the recent diagnostic criteria for Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease (MOGAD).

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A downward spiral undone: Jon Bratsch

Lying in an ICU bed as sick as he could get, Jon Bratsch thought he was past the point of no return. But when a Mayo Clinic Laboratories’ test revealed the source of his dire symptoms, everything changed. Today, Jon’s back to the life and family he loves.

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Update 2021: AQP4-IgG FACS assay

In this month’s “Hot Topic,” Sean Pittock, M.D., explains Neuromyelitis Optica Spectrum Disorder (NMOSD) and the critical importance of a sensitive and specific AQP4-IgG laboratory test for early diagnosis and treatment.

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References
  1. Pittock SJ, Lennon VA, Bakshi N, et al. Seroprevalence of aquaporin-4-IgG in a Northern California population representative cohort of multiple sclerosis. JAMA Neurol. 2014;71(11):1433-1436.
  2. Hamid SHM, et al. What proportion of AQP4-IgG-negative NMO spectrum disorder patients are MOG-IgG positive? A cross sectional study of 132 patients. J Neurol. 2017 Oct;264(10):2088-2094.
  3. Pittock SJ, Lennon VA, Bakshi N, et al. Seroprevalence of aquaporin-4-IgG in a Northern California population representative cohort of multiple sclerosis. JAMA Neurol. 2014;71(11):1433-1436.
  4. Water PJ, McKeon A, Leite MI, et al. Serologic diagnosis of NMO: a multicenter comparison of aquaporin-4-IgG assays. Neurology. 2012;78(9):665-671.
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