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Abstract

Objective:

To study the association between hormonal exposures and disease onset in a cohort of women with neuromyelitis optica spectrum disorder (NMOSD).

Methods:

Reproductive history and hormone use were assessed using a standardized reproductive survey administered to women with NMOSD (82% aquaporin-4 antibody positive) at 8 clinical centers. Using multivariable regression, we examined the association between reproductive exposures and age at first symptom onset (FS).

Results:

Among 217 respondents, the mean age at menarche was 12.8 years (SD 1.7). The mean number of pregnancies was 2.1 (SD 1.6), including 0.3 (SD 0.7) occurring after onset of NMOSD symptoms. In the 117 participants who were postmenopausal at the time of the questionnaire, 70% reported natural menopause (mean age: 48.9 years [SD 3.9]); fewer than 30% reported systemic hormone therapy (HT) use. Mean FS age was 40.1 years (SD 14.2). Ever-use of systemic hormonal contraceptives (HC) was marginally associated with earlier FS (39 vs 43 years, p = 0.05). Because HC use may decrease parity, when we included both variables in the model, the association between HC use and FS age became more significant (estimate = 2.7, p = 0.007). Among postmenopausal participants, 24% reported NMOSD onset within 2 years of (before or after) menopause. Among these participants, there was no association between age at menopause or HT use and age at NMOSD onset.

Conclusions:

Overall, age at NMOSD onset did not show a strong relationship with endogenous hormonal exposures. An earlier onset age did appear to be marginally associated with systemic HC exposure, an association that requires confirmation in future studies.
Neuromyelitis optica (NMO) is a severe inflammatory neurologic disease, whose main clinical manifestations are simultaneous or successive episodes of optic neuritis and transverse myelitis. NMO is associated with serum immunoglobulin G antibodies to aquaporin-4, which are present in about 75% of patients with NMO. “NMO-spectrum disorders” (NMOSDs) is a unifying term to describe the clinical spectrum of NMO, including aquaporin-4 antibody–positive patients with limited forms of the disease. The female-to-male ratio in NMOSD is up to 9:1,1,2 but the role of sex-specific hormones in disease pathogenesis has not been explored.
In MS, another CNS demyelinating disease with high female:male ratio (2–3:1 and possibly increasing3,4), earlier age at menarche is associated with earlier age at MS onset. Pregnancy reduces the risk of an MS relapse,5,6 and increasing parity is associated with lower risk of long-term disease progression.7 In NMOSD, the risk of relapses and of first disease onset is increased during the pregnancy and postpartum periods relative to baseline.811
In this cohort study, we hypothesized that, as seen in MS, both exogenous and endogenous hormonal exposures are associated with age at NMOSD onset. First, we describe the reproductive exposures of an international multicenter cohort of women with NMOSD; second, we examine the association between these hormonal exposures and age at disease onset.

METHODS

Setting.

A standardized reproductive survey was conducted between June 2011 and May 2013 for women with NMOSD (82% antibody positive) at 8 clinical centers, who were identified by chart review. These centers were as follows: Walton Centre in Liverpool, England (n = 56), Mayo Clinic-Rochester (n = 39), Washington University in St. Louis (n = 36), Charité - Universitätsmedizin Berlin (n = 26), Mayo Clinic-Scottsdale (n = 25), Johns Hopkins University (n = 19), and Massachusetts General Hospital/Brigham and Women's Hospital (n = 16).

Standard protocol approvals, registrations, and patient consents.

Informed consent was obtained from all participants under institutional review board policies at each site.

Participants.

A total of 217 women who met current published diagnostic criteria for NMOSD with or without aquaporin-4 antibodies12 were enrolled consecutively, and all participants completed at least 1 component of the questionnaire.

Questionnaire.

The reproductive survey included questions about menarche, pregnancies, menopause, and exogenous hormones.13 It was conducted using REDCap, a secure Health Insurance Portability and Accountability Act compliant web-based survey tool. This questionnaire had previously good concordance of selected variables against the medical record in women with MS.14 For this study, the following variables were examined:
1.
Age at menarche.
2.
Hormonal contraceptive (HC) use: Ever-use of HC was further divided by administration (oral, transdermal, IM) and duration (less than, vs at least, 12 months). The 12-month duration was selected because analyzing HC use over shorter timeframes might introduce more substantial recall bias. The formulation (estrogen, progestogen, or combined) or dosing of HC was not assessed.
3.
Number of pregnancies, including lifetime and after NMOSD first symptom onset (FS).
4.
Current reproductive status was categorized as cycling, perimenopausal (last menses in the 3–12 months prior to survey), or postmenopausal (no menses in the prior 12 months or loss of menses due to surgery). Type was categorized as (1) natural, or resulting from (2) surgical intervention (hysterectomy and/or bilateral oophorectomy) or (3) chemotherapy or radiation. Menopausal Age was defined as last menstrual period beyond which no menses occurred for 1 year (natural) or surgery date, according to Stages of Reproductive Aging Workshop +10 guidelines.15
5.
Menopausal hormone therapy (HT) use was categorized dichotomously for type (estrogen and/or progestogens vs other types [black cohosh, testosterone, etc]) and administration (systemic [patch + oral] vs local [gel, cream, and ring]), and for this analysis we included only systemic, homone-based HT.

Statistical analysis.

Descriptive statistics were used to summarize demographic, clinical, and reproductive characteristics. To examine the association between reproductive exposures and reported age at FS, we used multivariable regressions. Data were analyzed using the SAS-based software program JMP, version 8.0.1 (SAS Institute, Cary, NC).

RESULTS

Study population.

The demographic and disease characteristics of the 217 respondents are provided in table 1. Mean FS age was 40.1 years (SD 14.2, median 39.8, and interquartile range 28.0–51.6). There was no relationship between FS age and NMO antibody positivity (χ2, p = 0.68). With respect to hormonal exposures, the mean age at menarche was 12.8 years (SD 1.7), and 61% of women reported systemic oral HC use for at least 12-month duration. The median number of total pregnancies was 2 (SD 1.6) and occurring after NMOSD FS was 0 (SD 0.7). Thirteen percentage of respondents (26/193) reported delay in achieving pregnancy of 12 months or longer, and in the 11 in whom a reason for their infertility was identified, the causes were as follows: ovarian cysts (n = 3), structural problems (n = 3, including 1 endometriosis), hormonal dysregulation (n = 3), and male factors (n = 2). Twelve participants (6%) reported receiving infertility treatment.
Table 1 Demographic, clinical, and reproductive characteristics of 217 women with NMOSD from 8 participating clinical centers
Among the 117 postmenopausal participants, 70% (n = 82) reported natural menopause (mean age: 48.9 years [SD 3.9]); only 25% (n = 29) reported systemic HT use. Given prior reports that women with neurologic disabilities may access fewer components of general health promotion (such as cancer screening,16 or HT, which was often “standard of care” during the epoch corresponding to this cohort's menopausal transition17), we compared HT use in postmenopausal participants with FS occurring before vs after their final menstrual period. Women with FS after their menopause reported greater HT use (37%) than women with FS prior to menopause (16%; χ2 test = 5.68, p = 0.016). Association between reproductive exposures and age at disease onset is summarized in table 2:
Table 2 Summary of results

Menarche.

Ten participants (4.6%) reported FS prior to age of 18, 7 of whom reported FS within 2 years prior to (n = 2) or after (n = 5) menarche. There was no association between FS age and menarcheal age (linear regression, estimate = 0.91, p = 0.12).

HC use.

Ever-use of systemic HC was associated with earlier FS (39.3 vs 43.4 years), but this was marginally significant (linear regression, estimate = 2.1, p = 0.05; figure).
Figure Age at NMOSD first symptom onset in women with and without prior exposure to systemic hormonal contraceptives
NMOSD = neuromyelitis optica spectrum disorder.

Parity.

A later FS was also associated with a greater number of preceding pregnancies (estimate = 3.3, p < 0.0001). Because participant age confounded the interpretation (i.e., parity increases with age), we categorized individuals according to FS age (before 30, 30–39, 40–49, and 50 years and older). When we included this categorical term in the linear regression model, the association between FS age and number of preceding pregnancies was not significant (linear regression, estimate = 0.30, p = 0.16).
Because HC use might result in lower parity, we included both parity and HC use in a linear regression model, and the association between HC use and FS age became more significant (linear regression, estimate = 2.7, p = 0.007); the number of preonset pregnancies remained significant (linear regression, estimate = 3.3, p < 0.0001).

Menopause.

Among the 106 women who were postmenopausal at the time of the survey and who provided a menopausal age, there was no relationship between age at menopause and FS age (linear regression, estimate = 0.30, p = 0.10). Among these women, 59 (56%) reported FS after their final menstrual period and 25 (24%) reported FS within 2 years of their final menstrual period (n = 18 before and n = 7 after). In women with postmenopausal onset of FS, there was no relationship between systemic HT use and FS age (linear regression, estimate = 0.95, p = 0.66).
In sensitivity analyses, the significance of the findings reported was unchanged when we included race, ethnicity, and NMO antibody positivity as covariates in the models.

DISCUSSION

This study, conducted in a large international survey of women with NMOSD, represents a preliminary analysis of the relationship from NMOSD onset to hormonal factors beyond pregnancy.
With respect to endogenous exposures, unlike in MS, we saw no association between menarcheal age and NMOSD onset.1821 As in other cohorts, 5% of our participants reported FS before the age of 18.2,22 The association between a greater number of preceding pregnancies and later NMOSD FS (p < 0.0001) was expected, as parity increases with age. Future studies should examine the association between age at first offspring's birth (not available in our cohort) and FS age. It is important that the number of pregnancies after disease onset was far outnumbered by those prior to disease onset. While this may partly reflect the older age of women at FS, it may also reflect reproductive choices relating to uncertainty of disease course, need for new medications that have uncertain effects on a fetus, and concerns about the future ability to care for a child, as has been reported in MS.23 Inclusion of NMO antibody positivity in the sensitivity analyses did not change the significance (or nonsignificance) of the relationship between endogenous hormonal exposures and FS age. In a separate manuscript, we describe the association between pregnancy and relapses in this cohort (Klawiter, personal communication). It is notable that 6% of the respondents reported use of fertility treatments. Larger case-control studies adjusting for participant age are needed to determine whether there is an association between NMOSD and infertility.
With respect to exogenous exposures, we observed a marginally significant association between ever-use of HC and earlier age at NMOSD onset. From a broader perspective, evidence for an association between HC and autoimmune diseases is mixed (including lower,2426 neutral,27,28 and higher29 risk of MS) and likely is confounded by changing HC formulations across epochs. Furthermore, the confounding effect of delayed (or no) childbearing that is achieved through HC use has not been adequately assessed, nor has the effect of participant age on recall of HC use. Follow-up studies are required to confirm this association, and, if this is confirmed, to assess HC dosing effects and whether the association is causative.
Approximately, one-quarter of all participants reported a postmenopausal onset of FS, which contrasts with MS, where fewer than 10% develop MS FS after the age of 50.30 The detection rate of serum aquaporin-4 autoantibodies has been reported to increase in women relative to men particularly after the age of 50, suggesting an effect of reproductive immunosenescence on NMOSD features.22 We observed no relationship between FS age and reported NMO antibody positivity.
The primary strengths of this multicenter study include an international design with a relatively large sample size, the use of specific diagnostic criteria for NMOSD, and the use of a standardized fairly comprehensive reproductive survey. Still, numbers were overall low, participants were mostly Caucasians from European and North American centers, possibly limiting generalizability of findings, occasionally data were missing, and reliance on patient-reported hormonal exposures may have introduced recall bias. In addition, we were not adequately powered to detect epochal factors potentially associated with both exogenous hormone use and NMOSD susceptibility or disease course, or to detect differences across clinical centers. We also identified further refinements needed to the reproductive survey (e.g., age at first birth and HC formulations).
While we selected age at NMOSD as our initial clinical measure of interest, further studies should evaluate the association between endogenous and exogenous hormonal exposures and other NMOSD characteristics of interest, including clinical severity and progression, and severity of inflammation on MRI.
Studies that include detailed hormonal analysis and immunopathogenetic measures are required to replicate these results and further elucidate the role of endogenous and exogenous hormonal exposures on this female predominant autoimmune disease, as well as important pathophysiologic implications.

GLOSSARY

FS
first symptom onset
HC
hormonal contraceptives
HT
hormone therapy
NMO
neuromyelitis optica
NMOSD
neuromyelitis optica spectrum disorder

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Information & Authors

Information

Published In

Neurology® Neuroimmunology & Neuroinflammation
Volume 4Number 3May 2017
PubMed: 28382320

Publication History

Received: November 29, 2016
Accepted: January 26, 2017
Published online: March 24, 2017
Published in print: May 2017

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Disclosure

R. Bove received research support from NIH, Brigham and Women's Hospital BWPO, and National MS Society-American Brain Foundation. L. Elsone received travel funding from TEVA Pharmaceuticals and European Charcot Foundation. E. Alvarez received research support from Biogen, Novartis, Acorda, Genentech, and Rocky Mountain MS Center. N. Borisow, M.M. Cortez, and F.J. Mateen report no disclosures. M.A. Mealy received speaker honoraria from Consortium of Multiple Sclerosis Centers. K. Mutch and S. Tobyne report no disclosures. K. Ruprecht served on the scientific advisory board for Sanofi-Aventis/Genzyme, Novartis, and Roche; received travel funding and/or speaker honoraria from Bayer Healthcare, Biogen Idec, Merck Serono, Sanofi-Aventis/Genzyme, Teva Pharmaceuticals, Novartis, and Guthy-Jackson Charitable Foundation; is an academic editor for PLoS One; receives publishing royalties from Elsevier; and received research support from Novartis and German Ministry of Education and Research. G. Buckle received travel funding and/or speaker honoraria from, consulted, and served on the speakers' bureau for Biogen Idec, EMD Serono, Genentech, Genzyme Sanofi, Mallinckrodt, Novartis, and Teva. M. Levy served on the scientific advisory board for Asterias, Chugai, and Alexion; served on the editorial board for Multiple Sclerosis and Related Disorders; holds a patent for Aquaporin-4 sequence that elicits pathogenic T-cell response in animal model of neuromyelitis optica; has consulted for Guidepoint Global, Gerson Lehrman Group, and Cowen Group; received research support from Viropharma/Shire, Acorda, ApoPharma, Sanofi Genzyme, Alnylan, Alexion, Terumo BCT, National Institute of Neurological Disorders and Stroke, and Guthy-Jackson Charitable Foundation. D.M. Wingerchuk is co-editor-in-chief for The Neurologist; is an editorial board member for Current Medical Research and Opinion, Drugs in Context, and Journal of Clinical Apheresis; and received research support from Alexion and TerumoBCT. F. Paul served on the scientific advisory board for Novartis and MedImmune; received speaker honoraria and travel grants from Bayer, Novartis, Biogen Idec, Teva, Sanofi-Aventis/Genzyme, Merck Serono, Alexion, Chugai, MedImmune, and Shire; is an associate editor for Neurology® Neuroimmunology & Neuroinflammation; is an academic editor for PLoS One; has consulted for Sanofi Genzyme, Biogen Idec, MedImmune, Shire, and Alexion; and received research support from Bayer, Novartis, Biogen Idec, Sanofi-Aventis/Genzyme, Alexion, Merck Serono, German Research Council, Werth Stiftung of the City of Cologne, German Ministry of Education and Research, Arthur Arnstein Stiftung Berlin, EU FP7 Framework Program, Arthur Arnstein Foundation Berlin, Guthy-Jackson Charitable Foundation, and National Multiple Sclerosis Society of the USA. A.H. Cross served on the scientific advisory board for Roche and Genentech; received travel funding and/or speaker honoraria from Roche, EMD Serono, and AbbVie; served on the editorial board for Brain Pathology and the Journal of Neuroimmunology; was an associate editor for Annals Clinical Translational Neurology; has consulted for Biogen, Sanofi-Aventis/Genzyme, Novartis, Teva Neuroscience, Gerson Lehrman Group, Guidepoint Global, LLC, AbbVie, EMD Serono, Genentech, and Bayer; received honoraria for Projects in Knowledge, Prime Education, Inc., Race to ERASE MS, Conrad N. Hilton Foundation, WebMD; and received research support from Roche, Teva Neuroscience, OBOE, National Institute of Neurological Disorders and Stroke, Barnes-Jewish Hospital Foundation, and Conrad N. Hilton Foundation. B.G. Weinshenker served on the scientific advisory board for Novartis, Biogen Idec, and Mitsubishi Pharmaceuticals; served as an editorial board member for Canadian Journal of Neurological Sciences, Turkish Journal of Neurology, and Neurology; holds a patent for and receives royalties from NMO-IgG for diagnosis of neuromyelitis optica; is an adjudication committee member for MedImmune Pharmaceuticals and Alexion Pharmaceuticals; and received research support from the Guthy-Jackson Charitable Foundation. A. Jacobs served on the scientific advisory board for Shire Pharmaceuticals; received speaker honoraria from Biogen Idec and Shire Terumo BCT; has consulted for Shire Pharmaceuticals; and received research support from Alexion Pharmaceuticals, NHS, and University of Liverpool. E.C. Klawiter received consulting fees from Acorda Therapeutics, Atlas5D, Biogen Idec, EMD Serono, Genentech, and Shire; and received research support from Atlas5D, Biogen Idec, EMD Serono, Roche, NIH, National MS Society, and Guthy-Jackson Charitable Foundation. T. Chitnis served on the scientific advisory board for Novartis and Genzyme Sanofi; consulted for Biogen Idec, Novartis, Genzyme Sanofi, and Genentech-Roche; and received research support from EMD Serono, Novartis, Biogen, Verily, National Multiple Sclerosis Society, The Peabody Foundation, Consortium for MS Centers, and Guthy-Jackson Charitable Foundation. Go to Neurology.org/nn for full disclosure forms.

Study Funding

This work was supported by the Guthy-Jackson Charitable Foundation. R.B. was supported by the National Multiple Sclerosis Society and the NIH (BIRCWH K12). K.R. and F.P. were supported by the German ministry of education and research (BMBF/KKNMS, Competence Network Multiple Sclerosis).

Authors

Affiliations & Disclosures

Riley Bove, MD, MSc
From the Brigham and Women's Hospital (R.B., T.C.), Boston, MA; Harvard Medical School (R.B., F.J.M., E.C.K., T.C.), Boston, MA; The Walton Centre NHS Foundation Trust (L.E., K.M., A.J.), Liverpool, UK; Washington University School of Medicine (E.A., A.H.C.), St. Louis, MO; Charité—Universitätsmedizin Berlin (N.B., K.R., F.P.), Germany; University of Utah Imaging & Neurosciences Center (M.M.C.), Salt Lake City; Massachusetts General Hospital (F.J.M., S.T., E.C.K.), Boston; Johns Hopkins Medical Institute (M.A.M., M.L.), Baltimore, MD; MS Institute at Shepherd Center (G.B.), Atlanta, GA; Mayo Clinic (B.W.), Rochester, MN; and Mayo Clinic (D.M.W.), Scottsdale, AZ.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NIH T32 training grant. Role: mentee. PI: George Tsokos, PhD, Harvard Medical School. Dates: 5/11-5/12 NIH K12 BIRCWH Training grant. Role: mentee. PI: Jill Goldstein. Dates: 5/13- 4/14.
Research Support, Academic Entities:
1.
Brigham and Women's Hospital BWPO. Clinical staff (9/2011-9/2015). UCSF Medical staff (10/2015-current)
Research Support, Foundations and Societies:
1.
National MS Society-American Brain Foundation Clinical Scientist Grant; NMSS Career Transition Award
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Liene Elsone, MD
From the Brigham and Women's Hospital (R.B., T.C.), Boston, MA; Harvard Medical School (R.B., F.J.M., E.C.K., T.C.), Boston, MA; The Walton Centre NHS Foundation Trust (L.E., K.M., A.J.), Liverpool, UK; Washington University School of Medicine (E.A., A.H.C.), St. Louis, MO; Charité—Universitätsmedizin Berlin (N.B., K.R., F.P.), Germany; University of Utah Imaging & Neurosciences Center (M.M.C.), Salt Lake City; Massachusetts General Hospital (F.J.M., S.T., E.C.K.), Boston; Johns Hopkins Medical Institute (M.A.M., M.L.), Baltimore, MD; MS Institute at Shepherd Center (G.B.), Atlanta, GA; Mayo Clinic (B.W.), Rochester, MN; and Mayo Clinic (D.M.W.), Scottsdale, AZ.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
Received funding for a trip to attend scientific meeting from TEVA Pharmaceuticals (2011), European Charcot foundation (2010, 2011)
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Enrique Alvarez, MD, PhD
From the Brigham and Women's Hospital (R.B., T.C.), Boston, MA; Harvard Medical School (R.B., F.J.M., E.C.K., T.C.), Boston, MA; The Walton Centre NHS Foundation Trust (L.E., K.M., A.J.), Liverpool, UK; Washington University School of Medicine (E.A., A.H.C.), St. Louis, MO; Charité—Universitätsmedizin Berlin (N.B., K.R., F.P.), Germany; University of Utah Imaging & Neurosciences Center (M.M.C.), Salt Lake City; Massachusetts General Hospital (F.J.M., S.T., E.C.K.), Boston; Johns Hopkins Medical Institute (M.A.M., M.L.), Baltimore, MD; MS Institute at Shepherd Center (G.B.), Atlanta, GA; Mayo Clinic (B.W.), Rochester, MN; and Mayo Clinic (D.M.W.), Scottsdale, AZ.
Disclosure
Scientific Advisory Boards:
1.
Biogen, Genzyme, Novartis, Genentech
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
Biogen, Novartis, Acorda, Genentech, Rocky Mountain MS Center.
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Nadja Borisow, MD
From the Brigham and Women's Hospital (R.B., T.C.), Boston, MA; Harvard Medical School (R.B., F.J.M., E.C.K., T.C.), Boston, MA; The Walton Centre NHS Foundation Trust (L.E., K.M., A.J.), Liverpool, UK; Washington University School of Medicine (E.A., A.H.C.), St. Louis, MO; Charité—Universitätsmedizin Berlin (N.B., K.R., F.P.), Germany; University of Utah Imaging & Neurosciences Center (M.M.C.), Salt Lake City; Massachusetts General Hospital (F.J.M., S.T., E.C.K.), Boston; Johns Hopkins Medical Institute (M.A.M., M.L.), Baltimore, MD; MS Institute at Shepherd Center (G.B.), Atlanta, GA; Mayo Clinic (B.W.), Rochester, MN; and Mayo Clinic (D.M.W.), Scottsdale, AZ.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Melissa M. Cortez, DO
From the Brigham and Women's Hospital (R.B., T.C.), Boston, MA; Harvard Medical School (R.B., F.J.M., E.C.K., T.C.), Boston, MA; The Walton Centre NHS Foundation Trust (L.E., K.M., A.J.), Liverpool, UK; Washington University School of Medicine (E.A., A.H.C.), St. Louis, MO; Charité—Universitätsmedizin Berlin (N.B., K.R., F.P.), Germany; University of Utah Imaging & Neurosciences Center (M.M.C.), Salt Lake City; Massachusetts General Hospital (F.J.M., S.T., E.C.K.), Boston; Johns Hopkins Medical Institute (M.A.M., M.L.), Baltimore, MD; MS Institute at Shepherd Center (G.B.), Atlanta, GA; Mayo Clinic (B.W.), Rochester, MN; and Mayo Clinic (D.M.W.), Scottsdale, AZ.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Farrah J. Mateen, MD, PhD
From the Brigham and Women's Hospital (R.B., T.C.), Boston, MA; Harvard Medical School (R.B., F.J.M., E.C.K., T.C.), Boston, MA; The Walton Centre NHS Foundation Trust (L.E., K.M., A.J.), Liverpool, UK; Washington University School of Medicine (E.A., A.H.C.), St. Louis, MO; Charité—Universitätsmedizin Berlin (N.B., K.R., F.P.), Germany; University of Utah Imaging & Neurosciences Center (M.M.C.), Salt Lake City; Massachusetts General Hospital (F.J.M., S.T., E.C.K.), Boston; Johns Hopkins Medical Institute (M.A.M., M.L.), Baltimore, MD; MS Institute at Shepherd Center (G.B.), Atlanta, GA; Mayo Clinic (B.W.), Rochester, MN; and Mayo Clinic (D.M.W.), Scottsdale, AZ.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Maureen A. Mealy, RN, BSN, MSCN
From the Brigham and Women's Hospital (R.B., T.C.), Boston, MA; Harvard Medical School (R.B., F.J.M., E.C.K., T.C.), Boston, MA; The Walton Centre NHS Foundation Trust (L.E., K.M., A.J.), Liverpool, UK; Washington University School of Medicine (E.A., A.H.C.), St. Louis, MO; Charité—Universitätsmedizin Berlin (N.B., K.R., F.P.), Germany; University of Utah Imaging & Neurosciences Center (M.M.C.), Salt Lake City; Massachusetts General Hospital (F.J.M., S.T., E.C.K.), Boston; Johns Hopkins Medical Institute (M.A.M., M.L.), Baltimore, MD; MS Institute at Shepherd Center (G.B.), Atlanta, GA; Mayo Clinic (B.W.), Rochester, MN; and Mayo Clinic (D.M.W.), Scottsdale, AZ.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
Speaker honoraria from Consortium of Multiple Sclerosis Centers
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Kerry Mutch, RGN, MSc
From the Brigham and Women's Hospital (R.B., T.C.), Boston, MA; Harvard Medical School (R.B., F.J.M., E.C.K., T.C.), Boston, MA; The Walton Centre NHS Foundation Trust (L.E., K.M., A.J.), Liverpool, UK; Washington University School of Medicine (E.A., A.H.C.), St. Louis, MO; Charité—Universitätsmedizin Berlin (N.B., K.R., F.P.), Germany; University of Utah Imaging & Neurosciences Center (M.M.C.), Salt Lake City; Massachusetts General Hospital (F.J.M., S.T., E.C.K.), Boston; Johns Hopkins Medical Institute (M.A.M., M.L.), Baltimore, MD; MS Institute at Shepherd Center (G.B.), Atlanta, GA; Mayo Clinic (B.W.), Rochester, MN; and Mayo Clinic (D.M.W.), Scottsdale, AZ.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Sean Tobyne, MA
From the Brigham and Women's Hospital (R.B., T.C.), Boston, MA; Harvard Medical School (R.B., F.J.M., E.C.K., T.C.), Boston, MA; The Walton Centre NHS Foundation Trust (L.E., K.M., A.J.), Liverpool, UK; Washington University School of Medicine (E.A., A.H.C.), St. Louis, MO; Charité—Universitätsmedizin Berlin (N.B., K.R., F.P.), Germany; University of Utah Imaging & Neurosciences Center (M.M.C.), Salt Lake City; Massachusetts General Hospital (F.J.M., S.T., E.C.K.), Boston; Johns Hopkins Medical Institute (M.A.M., M.L.), Baltimore, MD; MS Institute at Shepherd Center (G.B.), Atlanta, GA; Mayo Clinic (B.W.), Rochester, MN; and Mayo Clinic (D.M.W.), Scottsdale, AZ.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Klemens Ruprecht, MD
From the Brigham and Women's Hospital (R.B., T.C.), Boston, MA; Harvard Medical School (R.B., F.J.M., E.C.K., T.C.), Boston, MA; The Walton Centre NHS Foundation Trust (L.E., K.M., A.J.), Liverpool, UK; Washington University School of Medicine (E.A., A.H.C.), St. Louis, MO; Charité—Universitätsmedizin Berlin (N.B., K.R., F.P.), Germany; University of Utah Imaging & Neurosciences Center (M.M.C.), Salt Lake City; Massachusetts General Hospital (F.J.M., S.T., E.C.K.), Boston; Johns Hopkins Medical Institute (M.A.M., M.L.), Baltimore, MD; MS Institute at Shepherd Center (G.B.), Atlanta, GA; Mayo Clinic (B.W.), Rochester, MN; and Mayo Clinic (D.M.W.), Scottsdale, AZ.
Disclosure
Scientific Advisory Boards:
1.
(1)sanofi-aventis/Genzyme (2)Novartis (3)Roche
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
(1)Bayer Healthcare, travel and speaker honoraria (2)Biogen Idec, travel and speaker honoraria (3)Merck Serono, travel and speaker honoraria (4)sanofi-aventis/Genzyme, travel and speaker honoraria (5)Teva Pharmaceuticals, travel and speaker honoraria (6)Novartis, travel and speaker honoraria (7)Guthy Jackson Charitable Foundation, travel honoraria
Editorial Boards:
1.
(1) PLOS ONE, Academic Editor, since 2013
Patents:
1.
NONE
Publishing Royalties:
1.
(1) Neurologie in Frage und Antwort, Elsevier, 2000-2015
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
(1) Novartis
Research Support, Government Entities:
1.
(1)German Ministry of Education and Research (BMBF/KKNMS, Competence Network Multiple Sclerosis)
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Guy Buckle, MD
From the Brigham and Women's Hospital (R.B., T.C.), Boston, MA; Harvard Medical School (R.B., F.J.M., E.C.K., T.C.), Boston, MA; The Walton Centre NHS Foundation Trust (L.E., K.M., A.J.), Liverpool, UK; Washington University School of Medicine (E.A., A.H.C.), St. Louis, MO; Charité—Universitätsmedizin Berlin (N.B., K.R., F.P.), Germany; University of Utah Imaging & Neurosciences Center (M.M.C.), Salt Lake City; Massachusetts General Hospital (F.J.M., S.T., E.C.K.), Boston; Johns Hopkins Medical Institute (M.A.M., M.L.), Baltimore, MD; MS Institute at Shepherd Center (G.B.), Atlanta, GA; Mayo Clinic (B.W.), Rochester, MN; and Mayo Clinic (D.M.W.), Scottsdale, AZ.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
Biogen-Idec, EMD-Serono, Genentech, Genzyme-Sanofi, Mallinckrodt, Novartis, Teva
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
Biogen-Idec, EMD-Serono, Genentech, Genzyme-Sanofi, Mallinckrodt, Novartis, Teva
Speakers' Bureaus:
1.
Biogen-Idec, EMD-Serono, Genentech, Genzyme-Sanofi, Mallinckrodt, Novartis, Teva
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
Biogen, Expert Witness, 2015-2016
Michael Levy, MD, PhD
From the Brigham and Women's Hospital (R.B., T.C.), Boston, MA; Harvard Medical School (R.B., F.J.M., E.C.K., T.C.), Boston, MA; The Walton Centre NHS Foundation Trust (L.E., K.M., A.J.), Liverpool, UK; Washington University School of Medicine (E.A., A.H.C.), St. Louis, MO; Charité—Universitätsmedizin Berlin (N.B., K.R., F.P.), Germany; University of Utah Imaging & Neurosciences Center (M.M.C.), Salt Lake City; Massachusetts General Hospital (F.J.M., S.T., E.C.K.), Boston; Johns Hopkins Medical Institute (M.A.M., M.L.), Baltimore, MD; MS Institute at Shepherd Center (G.B.), Atlanta, GA; Mayo Clinic (B.W.), Rochester, MN; and Mayo Clinic (D.M.W.), Scottsdale, AZ.
Disclosure
Scientific Advisory Boards:
1.
Asterias, Chugai, Alexion
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
Editorial Board member of Multiple Sclerosis and Related Disorders
Patents:
1.
1. Aquaporin-4 sequence that elicits pathogenic T cell response in animal model of neuromyelitis optica. 2. Description: patent covers use of peptide for diagnostic and therapeutic developments.
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
Guidepoint Global; Gerson Lehrman Group; Cowen Group
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
Viropharma/Shire, Acorda, ApoPharma and Sanofi, Genzyme, Alnylam, Alexion, Terumo BCT
Research Support, Government Entities:
1.
National Institute of Neurological Diseases and Stroke
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
Guthy-Jackson Charitable Foundation
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Dean M. Wingerchuk, MD
From the Brigham and Women's Hospital (R.B., T.C.), Boston, MA; Harvard Medical School (R.B., F.J.M., E.C.K., T.C.), Boston, MA; The Walton Centre NHS Foundation Trust (L.E., K.M., A.J.), Liverpool, UK; Washington University School of Medicine (E.A., A.H.C.), St. Louis, MO; Charité—Universitätsmedizin Berlin (N.B., K.R., F.P.), Germany; University of Utah Imaging & Neurosciences Center (M.M.C.), Salt Lake City; Massachusetts General Hospital (F.J.M., S.T., E.C.K.), Boston; Johns Hopkins Medical Institute (M.A.M., M.L.), Baltimore, MD; MS Institute at Shepherd Center (G.B.), Atlanta, GA; Mayo Clinic (B.W.), Rochester, MN; and Mayo Clinic (D.M.W.), Scottsdale, AZ.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
(1) The Neurologist, Co-Editor-in-Chief, 2014-present, (2) Current Medical Research and Opinion, Editorial Advisory Board member, 2006-present, (3) Drugs in Context, Editorial Advisory Board Member, 2012-present, (4) editorial board member, Journal of Clinical Apheresis
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
MedImmune
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
(1) Alexion,(2) TerumoBCT
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Friedemann Paul, MD
From the Brigham and Women's Hospital (R.B., T.C.), Boston, MA; Harvard Medical School (R.B., F.J.M., E.C.K., T.C.), Boston, MA; The Walton Centre NHS Foundation Trust (L.E., K.M., A.J.), Liverpool, UK; Washington University School of Medicine (E.A., A.H.C.), St. Louis, MO; Charité—Universitätsmedizin Berlin (N.B., K.R., F.P.), Germany; University of Utah Imaging & Neurosciences Center (M.M.C.), Salt Lake City; Massachusetts General Hospital (F.J.M., S.T., E.C.K.), Boston; Johns Hopkins Medical Institute (M.A.M., M.L.), Baltimore, MD; MS Institute at Shepherd Center (G.B.), Atlanta, GA; Mayo Clinic (B.W.), Rochester, MN; and Mayo Clinic (D.M.W.), Scottsdale, AZ.
Disclosure
Scientific Advisory Boards:
1.
Novartis OCTIMS study steering committee MedImmune steering committee
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
speaker honoraria and travel grants from Bayer, Novartis, Biogen Idec, Teva, Sanofi-Aventis / Genzyme, and Merck Serono, Alexion, Chugai, MedImmune, Shire
Editorial Boards:
1.
Academic Editor, PLoS ONE Associate Editor, Neurology Neuroimmunology and Neuroinflammation
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
consultancies for SanofiGenzyme, BiogenIdec, MedImmune, Shire, Alexion
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
Research support from from Bayer, Novartis, Biogen Idec, Teva, Sanofi-Aventis / Genzyme, Alexion and Merck Serono
Research Support, Government Entities:
1.
German Research Council (DFG Exc 257), Werth Stiftung of the City of Cologne, German Ministry of Education and Research (BMBF Competence Network Multiple Sclerosis), Arthur Arnstein Stiftung Berlin, EU FP7 Framework Program (combims.eu)
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
Arthur Arnstein Foundation Berlin, Guthy Jackson Charitable Foundation, National Multiple Sclerosis Society of the USA
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Anne H. Cross, MD
From the Brigham and Women's Hospital (R.B., T.C.), Boston, MA; Harvard Medical School (R.B., F.J.M., E.C.K., T.C.), Boston, MA; The Walton Centre NHS Foundation Trust (L.E., K.M., A.J.), Liverpool, UK; Washington University School of Medicine (E.A., A.H.C.), St. Louis, MO; Charité—Universitätsmedizin Berlin (N.B., K.R., F.P.), Germany; University of Utah Imaging & Neurosciences Center (M.M.C.), Salt Lake City; Massachusetts General Hospital (F.J.M., S.T., E.C.K.), Boston; Johns Hopkins Medical Institute (M.A.M., M.L.), Baltimore, MD; MS Institute at Shepherd Center (G.B.), Atlanta, GA; Mayo Clinic (B.W.), Rochester, MN; and Mayo Clinic (D.M.W.), Scottsdale, AZ.
Disclosure
Scientific Advisory Boards:
1.
(1) Roche, member scientific advisory board 2010-2016 (2) Genentech, member of scientific advisory board
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
(1) Gave talk for ROche at meeting for their scientists in Zurich Switzerland; (2) gave talk for EMD-Serono in Madrid 2016; (3) gave talk for Genentech California Sept 2015; (4) spoke at AbbVie meeting, Chicago
Editorial Boards:
1.
(1) Brain Pathology,Editorial Board, 2008-ongoing (2) Editorial Board, Journal of Neuroimmunology, Editorial Board, 1996- ongoing (3) 2013 -2016 Associate Editor of Annals Clinical Translational Neurology (I recently stepped down from this job)
Patents:
1.
One of four inventors of
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
(1)Biogen, ad hoc consultant, 2005-2016, (2) Sanofi- Aventis/ Genzyme, ad hoc consultant 2010 -2016 (3) Novartis, ad hoc consultant 2013- 2016; (4) Teva Neuroscience, ad hoc consultant 2009-2015, (5) Gerson Lehrman Group Austin Tx, consultant 2009-2016, (6) Guidepoint Global, LLC, New York, New York,consultant 2009-2016, (7) AbbVie - ad hoc consultant 2016; (8) EMD Serono - Ad hoc consultant 2012-2016; (9) Genentech - ad hoc consultant 2011-2016; (10) Bayer - ad hoc consultant 2016
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
(1) Projects in Knowledge, Livingston NJ 07039- fee for writing up 3 cases, with questions, etc.(2)Prime Education, Inc, fee for giving CME talk - 2016; (3) honoraria for reviewing grants for Race To ERASE MS 2016- 2017; (4) honoraria (expected) for reviewing grants for the Conrad N. Hilton Foundation 2017; (5) WebMD, honoraria for filming
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
(1) Roche site PI for study of ocrelizumab in primary progressive MS (ORATORIO- now in open-label extension), back-up investigator on a study at our site of ocrelizumab for RRMS (OPERA), both studies began in 2011 and are now in open-label extensions; (2) Teva Neuroscience - site PI in study of Vitamin D added at low versus high dose to glatiramer acetate. Study is funded by the National MS Society USA, but Teva is contributing free-of-charge Copaxone to study participants. Ongoing. (3) Site PI for OBOE, a study of ocrelizumab open label in which spinal fluid is being analyzed and compared before vs. after treatment.
Research Support, Government Entities:
1.
(1)National Institutes of Health NINDS 2PO1 NS059560- 01 ?Biomarkers and pathogenesis of MS: From Mouse to Human? Overall Principal Investigator, and PI of Project 3 and Core A. 2008-2013,and renewal 2014-2019.
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
(1) Barnes-Jewish Hospital Foundation, PI, 2005-2017 (2) Conrad N Hilton Foundation
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Brian Weinshenker, MD
From the Brigham and Women's Hospital (R.B., T.C.), Boston, MA; Harvard Medical School (R.B., F.J.M., E.C.K., T.C.), Boston, MA; The Walton Centre NHS Foundation Trust (L.E., K.M., A.J.), Liverpool, UK; Washington University School of Medicine (E.A., A.H.C.), St. Louis, MO; Charité—Universitätsmedizin Berlin (N.B., K.R., F.P.), Germany; University of Utah Imaging & Neurosciences Center (M.M.C.), Salt Lake City; Massachusetts General Hospital (F.J.M., S.T., E.C.K.), Boston; Johns Hopkins Medical Institute (M.A.M., M.L.), Baltimore, MD; MS Institute at Shepherd Center (G.B.), Atlanta, GA; Mayo Clinic (B.W.), Rochester, MN; and Mayo Clinic (D.M.W.), Scottsdale, AZ.
Disclosure
Scientific Advisory Boards:
1.
(1) Novartis data safety monitoring board member (2) Biogen Idec data safety monitoring board member (3) Mitsubishi Pharmaceuticals data safety monitoring board member
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
1. Canadian Journal of Neurological Sciences, editorial board member, 2006-present; no compensation 2. Turkish Journal of Neurology, editorial board member, 2005-present; no compensation 3. Neurology, editorial board member, 2014-present; no compensation
Patents:
1.
1) NMO-IgG for diagnosis of neuromyelitis optica; application 20050112116; patent issued and technology licensed to R.S.R. Ltd.,Oxford University and MVZ Labor PD Dr. Volkmann und Kollegen GbR
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
(1)MedImmune Pharmaceuticals, Adjudication Committee Member (2)Alexion Pharmaceuticals, Adjudication Committee Member
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
Guthy Jackson Charitable Foundation, sponsor of research in NMO, 10/2008-09/2011
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NMO-IgG for diagnosis of neuromyelitis optica; patent issued and technology licensed to R.S.R. Ltd., Oxford University and MVZ Labor PD Dr. Volkmann und Kollegen GbR
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Anu Jacob, MD, FRCP
From the Brigham and Women's Hospital (R.B., T.C.), Boston, MA; Harvard Medical School (R.B., F.J.M., E.C.K., T.C.), Boston, MA; The Walton Centre NHS Foundation Trust (L.E., K.M., A.J.), Liverpool, UK; Washington University School of Medicine (E.A., A.H.C.), St. Louis, MO; Charité—Universitätsmedizin Berlin (N.B., K.R., F.P.), Germany; University of Utah Imaging & Neurosciences Center (M.M.C.), Salt Lake City; Massachusetts General Hospital (F.J.M., S.T., E.C.K.), Boston; Johns Hopkins Medical Institute (M.A.M., M.L.), Baltimore, MD; MS Institute at Shepherd Center (G.B.), Atlanta, GA; Mayo Clinic (B.W.), Rochester, MN; and Mayo Clinic (D.M.W.), Scottsdale, AZ.
Disclosure
Scientific Advisory Boards:
1.
Shire Pharmaceuticals
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
Honoraria for speaking on NMO from Biogen Idec and Shire Terumo BCT, Pharamecuticals
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
Commercial EntityShire Pharmaceuticals
Speakers' Bureaus:
1.
Honoraria for speaking on NMO from Biogen Idec and Shire
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
Commericial Entity Biogen grantAlexion Pharamceuticals
Research Support, Government Entities:
1.
NHS -NMO service
Research Support, Academic Entities:
1.
UNIVERSITY OF LIVERPOOL
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Eric C. Klawiter, MD, MSc
From the Brigham and Women's Hospital (R.B., T.C.), Boston, MA; Harvard Medical School (R.B., F.J.M., E.C.K., T.C.), Boston, MA; The Walton Centre NHS Foundation Trust (L.E., K.M., A.J.), Liverpool, UK; Washington University School of Medicine (E.A., A.H.C.), St. Louis, MO; Charité—Universitätsmedizin Berlin (N.B., K.R., F.P.), Germany; University of Utah Imaging & Neurosciences Center (M.M.C.), Salt Lake City; Massachusetts General Hospital (F.J.M., S.T., E.C.K.), Boston; Johns Hopkins Medical Institute (M.A.M., M.L.), Baltimore, MD; MS Institute at Shepherd Center (G.B.), Atlanta, GA; Mayo Clinic (B.W.), Rochester, MN; and Mayo Clinic (D.M.W.), Scottsdale, AZ.
Disclosure
Scientific Advisory Boards:
1.
(1) Consulting fees from Acorda Therapeutics, Atlas5d, Biogen Idec, EMD Serono, Genentech, and Shire.
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
(1) Consulting fees from Acorda Therapeutics, Atlas5d, Biogen Idec, EMD Serono, Genentech, and Shire.
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
1) Research clinical trial support received from Atlas5d, Biogen Idec, EMD Serono, and Roche.
Research Support, Government Entities:
1.
1) National Institute of Health (1 K23 NS078044-01), PI, 2012-present
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
1) National MS Society (PP1853, RG-4729A2/1, PR-1412-02194), 2) Guthy Jackson Charitable Foundation
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Tanuja Chitnis, MD
From the Brigham and Women's Hospital (R.B., T.C.), Boston, MA; Harvard Medical School (R.B., F.J.M., E.C.K., T.C.), Boston, MA; The Walton Centre NHS Foundation Trust (L.E., K.M., A.J.), Liverpool, UK; Washington University School of Medicine (E.A., A.H.C.), St. Louis, MO; Charité—Universitätsmedizin Berlin (N.B., K.R., F.P.), Germany; University of Utah Imaging & Neurosciences Center (M.M.C.), Salt Lake City; Massachusetts General Hospital (F.J.M., S.T., E.C.K.), Boston; Johns Hopkins Medical Institute (M.A.M., M.L.), Baltimore, MD; MS Institute at Shepherd Center (G.B.), Atlanta, GA; Mayo Clinic (B.W.), Rochester, MN; and Mayo Clinic (D.M.W.), Scottsdale, AZ.
Disclosure
Scientific Advisory Boards:
1.
Dr. Chitnis has served on clinical trial advisory boards for Novartis Pharmaceuticals, and Genzyme-Sanofi.
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
Dr. Chitnis has served as a one-time consultant for Biogen-Idec, Novartis, Genzyme-Sanofi and Genentech-Roche.
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
Dr. Chitnis receives research support from (1) EMD-Serono, (2) Novartis, (3) Biogen (4) Verily, in the form of Independent Investigator Awards.
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
Dr. Chitnis receives research support from the National Multiple Sclerosis Society, the Peabody Foundation, the Consortium for MS Centers and the Guthy-Jackson Charitable Foundation.
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE

Notes

Correspondence to Dr. Chitnis: [email protected]
Funding information and disclosures are provided at the end of the article. Go to Neurology.org/nn for full disclosure forms. The Article Processing Charge was paid by the authors.

Author Contributions

Study concept and design: R.B., E.C.K., and T.C. Statistical analysis and interpretation of data: R.B. and F.J.M. Acquisition of data and interpretation of results: L.E., E.A., N.B., M.M.C., F.J.M., M.A.M., K.M., S.T., K.R., G.B., M.L., D.M.W., F.P., A.H.C., B.W., A.J., E.C.K., and T.C. Manuscript drafting and revising: R.B., L.E., E.A., N.B., M.M.C., F.J.M., M.A.M., K.M., S.T., K.R., G.B., M.L., D.M.W., F.P., A.H.C., B.W., A.J., E.C.K., and T.C.

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