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Update on biomarkers in neuromyelitis optica
Esther Melamed1, Michael Levy1, Patrick J Waters1
1Stanford University (E.M., M.H.H.), Stanford, CA; Johns Hopkins University (M.L.), Baltimore, MD; University of Oxford (P.J.W.), UK; Tohoku University (D.K.S.), Sendai, Japan; University of São Paulo (D.K.S.), Brazil; University of Colorado (J.L.B.), Denver; Mt. Sinai University (G.R.J.), New York, NY; Thomas Jefferson University (D.C.H.), Philadelphia, PA; IDIBAPS (A.S.), Barcelona, Spain; Montreal Neurological Institute and Hospital (A.B.-O.), McGill University, Montreal, Quebec, Canada; Research Institute and Hospital of National Cancer Center (H.J.K.), Goyang, Korea; KS Hegde Medical Academy (L.P.), Nitte University, Mangalore, India; Oxford University Hospital (M.I.L.), Oxford, UK; University of Southern Denmark (N.A.), Odense; Vejle Hospital (N.A.), Denmark; University Hospital (N.K.), Marrakech, Morocco; MS Center (R.H.), Erasmus MC University Medical Center, Rotterdam, the Netherlands; Service de Neurologie A (R.M.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron, France; Molecular Neuroimmunology (S.J.), Department of Neurology, University Hospital Heidelberg, Germany; Tandem Labs (J.M.), San Diego, CA; University of Michigan Medical School (T.J.S.), Ann Arbor, MI; and David Geffen School of Medicine (M.R.Y.), University of California, Los Angeles.
Biomarkers are crucial for neuromyelitis optica (NMO) management. This review explores current and potential biomarkers, including aquaporin-4 antibodies, to improve diagnosis and treatment for NMO spectrum disorder.
Area of Science:
- Neuroimmunology
- Central Nervous System (CNS) Autoimmune Disorders
Background:
- Neuromyelitis optica (NMO) and NMO spectrum disorder are autoimmune CNS diseases targeting the spinal cord and optic nerves.
- Current diagnostic and prognostic tools for NMO are limited by heterogeneous clinical presentations and variable treatment responses.
Purpose of the Study:
- To review known and potential biomarkers for neuromyelitis optica (NMO).
- To highlight the urgent need for reliable biomarkers for NMO onset, relapse, and progression.
Main Methods:
- Review of existing literature on neuromyelitis optica (NMO) biomarkers.
- Discussion of aquaporin-4 (AQP4) antibodies (AQP4-IgG) in seropositive NMO diagnosis.
Main Results:
- Aquaporin-4 antibodies (AQP4-IgG) aid in diagnosing seropositive NMO.
- The correlation of AQP4-IgG levels with disease activity, severity, and outcomes remains unclear.
- Biomarkers for seronegative NMO are not yet established.
Conclusions:
- Reliable biomarkers are essential for effective NMO management and clinical trials.
- International collaborative studies are vital for biomarker validation in NMO.
- Further research is needed to define and validate biomarkers for both seropositive and seronegative NMO.

