title: Clinical Features of Patients with Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders.
abstract: BACKGROUND
  Neuromyelitis optica spectrum disorder (NMOSD) was long believed to be an aggressive form of multiple sclerosis (MS). This study aimed to describe the clinical features of patients with MS and NMOSD to assist in differential diagnoses in clinical practice.
  
  
  METHODS
  Data including the patients' serum and cerebrospinal fluid (CSF) tests, image findings, and clinical information from 175 patients with MS or NMOSD at Xuanwu Hospital, Capital Medical University from November 2012 to May 2014 were collected and analyzed retrospectively. An enzyme-linked immunosorbent assay was performed to detect the myelin oligodendrocyte glycoprotein (MOG) autoantibodies in CSF and serum. Cell-based assays were used to detect aquaporin-4-antibody (AQP4-Ab). The Chi-square test was used to compare the categorical variables. Wilcoxon rank sum test was performed to analyze the continuous variables.
  
  
  RESULTS
  Totally 85 MS patients (49%) and 90 NMOSD patients (51%) were enrolled, including 124 (71%) women and 51 (29%) men. Fewer MS patients (6%) had autoimmune diseases compared to NMOSD (19%) (Δ2 = 6.9, P < 0.01). Patients with NMOSD had higher Expanded Disability Status Scale scores (3.5 [3]) than MS group (2 [2]) (Z = -3.69, P < 0.01). The CSF levels of white cell count and protein in both two groups were slightly elevated than the normal range, without significant difference between each other. Positivity of serum AQP4-Ab in NMOSD patients was higher than that in MS patients (MS: 0, NMOSD: 67%; Δ2 = 63.9, P < 0.01). Oligoclonal bands in CSF among NMOSD patients were remarkably lower than that among MS (MS: 59%, NMOSD: 20%; Δ2 = 25.7, P < 0.01). No significant difference of MOG autoantibodies was found between the two groups.
  
  
  CONCLUSIONS
  The different CSF features combined with clinical, magnetic resonance imaging, and serum characteristics between Chinese patients with MS and NMOSD could assist in the differential diagnosis.
authors: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
authors: Hai
authors: H
authors: Chen
authors: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
authors: Shi-Meng
authors: SM
authors: Liu
authors: Department of Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
authors: Xu-Xiang
authors: XX
authors: Zhang
authors: Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
authors: Ya-Ou
authors: YO
authors: Liu
authors: Department of Endocrinology and Rheumatology, Navy General Hospital, Beijing 100037, China.
authors: Si-Zhao
authors: SZ
authors: Li
authors: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
authors: Zheng
authors: Z
authors: Liu
authors: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
authors: Hui-Qing
authors: HQ
authors: Dong
mesh_terms: D000293:Adolescent; D000328:Adult; D051401:Aquaporin 4 / Q000097:blood / Q000134:cerebrospinal fluid; D001323:Autoantibodies / Q000097:blood / Q000134:cerebrospinal fluid; D003711:Demyelinating Diseases / Q000097:blood / Q000134:cerebrospinal fluid / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000097:blood / Q000134:cerebrospinal fluid / Q000473:pathology*; D063308:Myelin-Oligodendrocyte Glycoprotein / Q000097:blood / Q000134:cerebrospinal fluid; D009471:Neuromyelitis Optica / Q000097:blood / Q000134:cerebrospinal fluid / Q000473:pathology*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D051401:Aquaporin 4; D001323:Autoantibodies; D063308:Myelin-Oligodendrocyte Glycoprotein