{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T13:25:22Z","timestamp":1788009922497,"version":"build-2784847793"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T00:00:00Z","timestamp":1728950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to evaluate the diagnostic accuracy of dried blood spot (DBS) compared with conventional serum Aquaporin\u20104\u2010IgG (AQP4\u2010IgG) testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective multicenter diagnostic study was conducted between April 2018 and October 2023 across medical centers in the United States, Uganda, and the Republic of Guinea. Neuromyelitis optica spectrum disorder (NMOSD) patients and controls collected blood on filter paper cards along with concurrent serum samples. These samples underwent analysis using flow cytometric live\u2010cell\u2010based assays (CBA) and enzyme\u2010linked immunosorbent assay (ELISA) to determine AQP4 serostatus. The accuracy of AQP4\u2010IgG detection between DBS and serum (gold standard) was compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 150 participants (47 cases, 103 controls), there was a strong correlation between DBS and serum samples (Spearman's correlation coefficient of 0.82). The AUC was 0.97 (95% CI: 0.92\u20130.99). AQP4\u2010IgG detection through DBS showed 87.0% sensitivity (95% CI: 0.74\u20130.95) and 100% specificity (95% CI: 0.96\u20131.00) using CBA, and 65.2% sensitivity (95% CI: 0.43\u20130.84) and 95.2% specificity (95% CI: 0.76\u20130.99) using ELISA. Serum ELISA demonstrated 69.6% sensitivity (95% CI: 0.47\u20130.87) and 98.4% specificity (95% CI: 0.91\u20130.99). The stability of DBS in detecting AQP4\u2010IgG persisted over 24\u2009months for most cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>The DBS represents a viable alternative for detecting AQP4\u2010IgG in resource\u2010limited settings to diagnose NMOSD, offering high sensitivity and specificity comparable to serum testing. Moreover, DBS has low shipping costs, is easy to administer, and is suitable for point\u2010of\u2010care testing.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.52178","type":"journal-article","created":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T23:44:21Z","timestamp":1729035861000},"page":"2855-2865","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Dried blood spot improves global access to aquaporin\u20104\u2010<scp>IgG<\/scp> testing for neuromyelitis optica"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0751-8967","authenticated-orcid":false,"given":"Nisa","family":"Vorasoot","sequence":"first","affiliation":[{"name":"Department of Neurology Mayo Clinic  Rochester Minnesota USA"},{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic  Rochester Minnesota USA"},{"name":"Center of MS and Autoimmune Neurology Mayo Clinic  Rochester Minnesota 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