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Abstract
Despite its close association with CNS inflammatory demyelinating disorders (CIDDs), pathogenic characteristics of idiopathic transverse myelitis (ITM) remain largely unknown. Here, we investigated serum levels of neurofilament light chain (sNfL) and glial fibrillary acidic protein (sGFAP) in patients with ITM to unravel the disease characteristics of ITM. We prospectively recruited 70 patients with ITM, 62 with AQP4 + NMOSD and 85 with RRMS—including 31 patients with acute TM attacks—along with 30 HCs. We measured sNfL and sGFAP levels using single-molecular arrays and compared these levels per lesion volume between the disease groups during attacks. Compared to HCs, ITM patients showed higher sNfL and sGFAP during acute attacks (sNfL: p < 0.001, sGFAP: p = 0.024), while those in remission (sNfL: p = 0.944, sGFAP: p > 0.999) did not, regardless of lesion extents and presence of multiple attacks. ITM patients demonstrated lower sGFAP/volume (p = 0.011) during acute attacks and lower sGFAP (p < 0.001) in remission compared to AQP4 + NMOSD patients. These findings suggest that both neuronal and astroglial damages occur in patients with acute ITM attacks at a similar level to those with RRMS, distinct from AQP4 + NMOSD. However, active neuroinflammatory process was not remarkable during remission in this cohort.
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1 University of Ulsan College of Medicine, Department of Neurology, Asan Medical Center, Seoul, South Korea (GRID:grid.267370.7) (ISNI:0000 0004 0533 4667)
2 University of Ulsan College of Medicine, Department of Neurology, Asan Medical Center, Seoul, South Korea (GRID:grid.267370.7) (ISNI:0000 0004 0533 4667); Asan Medical Center, Asan Medical Institute of Convergence Science and Technology, Seoul, South Korea (GRID:grid.413967.e) (ISNI:0000 0001 0842 2126)
3 University of Ulsan College of Medicine, Department of Convergence Medicine, Asan Medical Center, Seoul, South Korea (GRID:grid.267370.7) (ISNI:0000 0004 0533 4667)
4 Asan Medical Center, Asan Medical Institute of Convergence Science and Technology, Seoul, South Korea (GRID:grid.413967.e) (ISNI:0000 0001 0842 2126)