{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T02:38:39Z","timestamp":1782959919747,"version":"3.54.5"},"reference-count":73,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,9,19]],"date-time":"2023-09-19T00:00:00Z","timestamp":1695081600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Zhejiang Provincial Natural Science Foundation of China","award":["LQ23H090004"],"award-info":[{"award-number":["LQ23H090004"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,9]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>The overlapping of two or more types of neural autoantibodies in one patient has increasingly been documented in recent years. The coexistence of myelin oligodendrocyte glycoprotein (MOG) and N-methyl-d-aspartate receptor (NMDAR) antibodies is most common, which leads to a unique condition known as the MOG antibody and NMDAR antibody overlapping syndrome (MNOS). Here, we have reviewed the pathogenesis, clinical manifestations, paraclinical features, and treatment of MNOS. Forty-nine patients with MNOS were included in this study. They were young males with a median onset age of 23 years. No tumors were observed in the patients, and 24 of them reported prodromal symptoms. The most common clinical presentations were psychiatric symptoms (35\/49) and seizures (25\/49). Abnormalities on magnetic resonance imaging involved the brainstem (11\/49), cerebellum (9\/49), and parietal lobe (9\/49). Most patients mostly responded to immunotherapy and had a good long-term prognosis. However, the overall recurrence rate of MNOS was higher than that of mono antibody-positive diseases. The existence of concurrent NMDAR antibodies should be suspected in patients with MOG antibody-associated disease having psychiatric symptoms, seizures, movement disorders, or autonomic dysfunction. Similarly, serum MOG antibody testing should be performed when patients with anti-NMDAR encephalitis present with atypical clinical manifestations, such as visual impairment and limb weakness, and neuroradiological findings, such as optic nerve, spinal cord, or infratentorial involvement or meningeal enhancement. Early detection of the syndrome and prompt treatment can be beneficial for these patients, and maintenance immunosuppressive therapy is recommended due to the high overall recurrence rate of the syndrome.<\/jats:p>","DOI":"10.1093\/cei\/uxad109","type":"journal-article","created":{"date-parts":[[2023,9,19]],"date-time":"2023-09-19T10:02:16Z","timestamp":1695117736000},"page":"27-36","source":"Crossref","is-referenced-by-count":17,"title":["Myelin oligodendrocyte glycoprotein antibody and <i>N<\/i>-methyl-<scp>d<\/scp>-aspartate receptor antibody overlapping syndrome: insights from the recent case reports"],"prefix":"10.1093","volume":"215","author":[{"given":"Bing-Qing","family":"Du","sequence":"first","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University , Hangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi-Lun","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Neurology, Zhejiang Hospital , Hangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Er-Chuang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University , Hangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng-Ting","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University , Hangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gao-Li","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Zhejiang Chinese Medicine and Western Medicine Integrated Hospital , Hangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Hong","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University , Hangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4462-171X","authenticated-orcid":false,"given":"Yin-Xi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University , Hangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei-Ping","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University , Hangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,9,19]]},"reference":[{"key":"2024011000445588500_CIT0001","doi-asserted-by":"crossref","first-page":"102153","DOI":"10.1016\/j.msard.2020.102153","article-title":"Overlapping demyelinating syndrome (Neuromyelitis optica spectrum disorders NMOSD with anti-NMDA receptor encephalitis); a case report","volume":"42","author":"Sinani","year":"2020","journal-title":"Mult Scler Relat Disord"},{"key":"2024011000445588500_CIT0002","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1186\/s12883-021-02381-8","article-title":"Overlapping syndrome mimicking infectious meningoencephalitis in a patient with MOG and GFAP IgG","volume":"21","author":"Ji","year":"2021","journal-title":"BMC Neurol"},{"key":"2024011000445588500_CIT0003","doi-asserted-by":"crossref","first-page":"102468","DOI":"10.1016\/j.msard.2020.102468","article-title":"Coexistent MOG, NMDAR, CASPR2 antibody positivity: triumph over the triumvirate","volume":"46","author":"Cherian","year":"2020","journal-title":"Mult Scler Relat Disord"},{"key":"2024011000445588500_CIT0004","doi-asserted-by":"crossref","first-page":"711376","DOI":"10.3389\/fneur.2021.711376","article-title":"Clinical features of coexisting anti-NMDAR and MOG antibody-associated encephalitis: a systematic review and meta-analysis","volume":"12","author":"Ding","year":"2021","journal-title":"Front Neurol"},{"key":"2024011000445588500_CIT0005","first-page":"20552173221128170","article-title":"Autoimmune diseases and cancers overlapping with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD): a systematic review","volume":"8","author":"Molazadeh","year":"2022","journal-title":"Mult Scler J Exp Transl Clin"},{"key":"2024011000445588500_CIT0006","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.msard.2018.01.007","article-title":"Comparison of myelin oligodendrocyte glycoprotein (MOG)-antibody disease and AQP4-IgG-positive neuromyelitis optica spectrum disorder (NMOSD) when they co-exist with anti-NMDA (N-methyl-d-aspartate) receptor encephalitis","volume":"20","author":"Fan","year":"2018","journal-title":"Mult Scler Relat Disord"},{"key":"2024011000445588500_CIT0007","doi-asserted-by":"crossref","first-page":"103020","DOI":"10.1016\/j.msard.2021.103020","article-title":"Overlapping syndrome of anti-N-methyl-d-aspartate receptor encephalitis and anti-myelin oligodendrocyte glycoprotein inflammatory demyelinating diseases: a distinct clinical entity","volume":"52","author":"Chen","year":"2021","journal-title":"Mult Scler Relat Disord"},{"key":"2024011000445588500_CIT0008","doi-asserted-by":"crossref","first-page":"100338","DOI":"10.1016\/j.ebr.2019.100338","article-title":"Overlapping demyelinating syndrome and anti-N-methyl-d-aspartate receptor encephalitis with seizures","volume":"12","author":"Taraschenko","year":"2019","journal-title":"Epilepsy Behav Rep"},{"key":"2024011000445588500_CIT0009","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1186\/s12888-021-03269-0","article-title":"Anti-NMDA receptor encephalitis and overlapping demyelinating disorder in a 20-year old female with borderline personality disorder: proposal of a diagnostic and therapeutic algorithm for autoimmune encephalitis in psychiatric patients \u201ccase report\u201d","volume":"21","author":"Weiss","year":"2021","journal-title":"BMC Psychiatry"},{"key":"2024011000445588500_CIT0010","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1002\/ana.24117","article-title":"Overlapping demyelinating syndromes and anti-N-methyl-d-aspartate receptor encephalitis","volume":"75","author":"Titulaer","year":"2014","journal-title":"Ann Neurol"},{"key":"2024011000445588500_CIT0011","doi-asserted-by":"crossref","first-page":"e2302","DOI":"10.1212\/WNL.0000000000009239","article-title":"Clinical significance of anti-NMDAR concurrent with glial or neuronal surface antibodies","volume":"94","author":"Martinez-Hernandez","year":"2020","journal-title":"Neurology"},{"key":"2024011000445588500_CIT0012","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1111\/ene.13790","article-title":"Encephalitis is an 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