2011;18:69C79. 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%) ( 0.01). Patients with NMOSD had higher Expanded Disability Status Scale scores (3.5 [3]) than MS group (2 [2]) (= ?3.69, 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%; Z-DEVD-FMK 0.01). Oligoclonal bands in CSF among NMOSD patients Z-DEVD-FMK were remarkably lower than that among MS (MS: 59%, NMOSD: 20%; 0.01). No significant difference of MOG autoantibodies was found between the two groups. Conclusion: 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. values are two-sided. 0.05 was considered to be statistically significant. RESULTS Clinical characteristics The 175 patients with CNS IIDDs included 85 MS patients (49%) and 90 NMOSD patients (51%) [Table 1]. They were 124 (71%) women and 51 Z-DEVD-FMK (29%) men. The overall demographic characteristics of the two groups were similar, with no significant differences in gender or age observed [Table 1]. Table 1 Basic characteristics, clinical manifestation, and auxiliary examination results of patients with MS or NMOSD in this study = 85)= 90)(%)5 (6)17 (19)6.90* 0.01MRI findings, (%)?Midbrain lesions frequency16 (20)6 (7)6.90* 0.01?Pontine lesions frequency39 (49)22 (25)11.00* 0.01?Medulla lesions frequency18 (23)24 (27)0.39*0.53?Periventricular lesions frequency52 (66)20 (22)32.10* 0.01?Juxtacortical frequency29 (37)8 (9)18.70* 0.01?Infratentorial lesions frequency14 (18)3 (3)9.50* 0.01?Long-cord lesions ( 3 VS) frequency19 (21)14 (61)14.70* 0.01CSF analysis?CSF-WBC count (106/L), median (IQR)5 (8)5 (8)0.46?0.64?CSF protein (mg/L), median (IQR)320 (290)360 Slc2a4 (310)1.67?0.10?AQP4-Ab CSF positive frequency, (%)030 (46)36.40* 0.01?CSF-SOB frequency, (%)46 (59)16 (20)25.70* 0.01?CSF-MBP frequency, (%)9 (19)16 (42)5.90*0.02?CSF-MOG-Ab (IQR)0.45 (0.34)0.33 (0.51)0.37?0.72Serum analysis?AQP4-Ab seropositive frequency, (%)047 (67)63.90* 0.01?Serum MOG-Ab (IQR)0.72 (0.81)0.47 (0.47)2.04?0.04 Open in a separate window *values. MS: Multiple sclerosis; NMOSD: Neuromyelitis optica spectrum Z-DEVD-FMK disease; IQR: Interquartile range; EDSS: Expanded Disability Status Scale; VS: Vertebral segments; CSF: Cerebrospinal fluid; WBC: White blood cell; AQP4-Ab: Aquaporin-4-antibody; SOB: Specific oligoclonal bands; MBP: Myelin basic protein; MOG-Ab: Myelin oligodendrocyte glycoprotein antibody. Twenty-two patients (13%) had autoimmune diseases, including Behcet’s disease, Hashimoto’s thyroiditis, allergic asthma, Sjogren syndrome, Crohn’s disease, idiopathic thrombocytopenic purpura, and connective tissue disease (CTD). Fewer MS patients (6%) had autoimmune diseases compared to NMOSD (19%) ( 0.01). Paralysis, anesthesia, and decreased eyesight were the most common symptoms among the 175 patients. Expanded Disability Status Scale (EDSS) scores (range in 0.0C10.0, with 0.0 indicates normal neurological exams and 10.0 indicates death) show significant difference among groups: patients with NMOSD have higher EDSS scores (3.5 [3]) than MS group (2 [2]) (= ?3.69, 0.01). Results of cerebrospinal fluid and serum tests Routine test and biochemical analysis of cerebrospinal fluid The CSF results for a routine test and biochemical analysis (including white cell count, CSF protein, glucose, and chloride levels) were available for all MS patients and 82 (91%) patients with NMOSD. CSF white cell count was 5 (8) 106/L for each group (= 0.46, = 0.64), respectively. CSF protein was 330 (310) mg/L for all samples, 320 (290) mg/L with MS, and 360 (310) mg/L with NMOSD, respectively (= 1.67, = 0.10). CSF glucose was 550 (100) mg/L for all samples, 544 (82) mg/L with MS, and 560 (104) mg/L with NMOSD, respectively (= 0.97, = 0.33). CSF chloride was 116 (5) mmol/L for all samples, 116 (5) mmol/L with MS, and 115 (5) mmol/L with NMOSD, respectively (= ? 0.15, = 0.88). Aquaporin-4-antibody detection in cerebrospinal fluid and serum AQP4-Ab in CSF and serum was detected from 131 (75%) patients. Totally 47 patients were positive for serum AQP4-Ab by immunohistochemistry: none with MS and 47 with NMOSD ( 0.01); while thirty patients were positive for CSF AQP4-Ab: none with MS, thirty patients with NMOSD ( 0.01). Specific oligoclonal bands in cerebrospinal fluid CSF-SOB frequency in patients with MS was 59%, while it was only 20% with NMOSD ( 0.01). Myelin basic protein in cerebrospinal fluid CSF samples were Z-DEVD-FMK available for MBP test in 49 MS and 38 NMOSD patients. No significant difference was found in the CSF MBP positivity between groups: 19% in MS group and 42% in NMOSD group (= 0.02). Myelin oligodendrocyte glycoprotein antibodies in cerebrospinal fluid and serum MOG-Ab in CSF and serum was detected from 31 patients: 12 had MS and 19 had NMOSD. The median age at symptoms onset of serum MOG-Ab positive.