Overlapping CNS inflammatory syndromes: separating NMO from MS

• Research type

  Research Study

• Full title

  Overlapping CNS inflammatory syndromes: separating neuromyelitis optica (NMO) from multiple sclerosis (MS).

• IRAS ID

  157305

• Contact name

  Jacqueline Palace

• Contact email

  jacqueline.palace@ndcn.ox.ac.uk

• Sponsor organisation

  Oxford University Hospitals Research and Development

• Duration of Study in the UK

  1 years, 11 months, 31 days

• Research summary

  Neuromyelitis optica (NMO) and multiple sclerosis (MS) are two separate inflammatory diseases of the brain and spinal cord, which often present with similar symptoms. The differential diagnosis is difficult, particularly in patients who do not have the NMO-specific aquaporin-4 antibodies in the serum. The accurate diagnosis is crucial in these patients as both diseases respond differently to treatment and MS drugs often exacerbate NMO, which is a severely disabling and life-shortening disease.
  This study aims at separating and classifying patients who are at the interface of NMO and MS (NMO/MS overlap patients) in order to improve their diagnosis and treatment. Patients participating in this study will be recruited from the nationally funded NMO service which is run by Dr Palace and Dr Leite in John Radcliffe Hospital in Oxford. The primary objective of the study will be to separate NMO/MS overlap patients into 2 groups (e.g. 'NMO-like' and 'MS-like') by performing cluster analysis using various NMO/MS discriminators associated with conventional and non-conventional MRI, serum and CSF analysis, visual evoked potentials and optical coherence tomography of the retina. The analysis will include discriminators which have been previously shown to distinguish typical AQP4-postive NMO from classical MS. Secondary objectives of the study will involve 1) comparing separated groupings of patients with the clinicians best clinical diagnosis, 2) assessing how diagnostic discriminators associate with each other and 3) identifying the discriminators that best predict the physician best clinical diagnosis. Identification of valuable diagnostic discriminators will immediately translate into clinical practice to help differential diagnosis and the choice of safe and effective treatment in NMO/MS overlap patients.

• REC name

  Wales REC 7

• REC reference

  14/WA/1252

• Date of REC Opinion

  3 Dec 2014

• REC opinion

  Favourable Opinion