sj-tif-3-msj-10.1177_13524585221109397 – Supplemental material for A disproportionality analysis for the association of central nervous system demyelinating diseases with COVID-19 vaccination using the World Health Organization pharmacovigilance database

Supplemental material, sj-tif-3-msj-10.1177_13524585221109397 for A disproportionality analysis for the association of central nervous system demyelinating diseases with COVID-19 vaccination using the World Health Organization pharmacovigilance database by Jee-Eun Kim, Jin Park and Tae-Jin Song in Multiple Sclerosis Journal</p

sj-tif-2-msj-10.1177_13524585221109397 – Supplemental material for A disproportionality analysis for the association of central nervous system demyelinating diseases with COVID-19 vaccination using the World Health Organization pharmacovigilance database

Supplemental material, sj-tif-2-msj-10.1177_13524585221109397 for A disproportionality analysis for the association of central nervous system demyelinating diseases with COVID-19 vaccination using the World Health Organization pharmacovigilance database by Jee-Eun Kim, Jin Park and Tae-Jin Song in Multiple Sclerosis Journal</p

Table_1_The Global Burden of Motor Neuron Disease: An Analysis of the 2019 Global Burden of Disease Study.docx

Up-to-date, accurate information on the disease burden of motor neuron disease (MND) is the cornerstone for evidence-based resource allocation and healthcare planning. We aimed to estimate the burden of MND globally from 1990 to 2019, as part of the Global Burden of Disease, Injuries and Risk Factor (GBD) study. Amyotrophic lateral sclerosis, progressive muscular atrophy, primary lateral sclerosis, pseudobulbar palsy, spinal muscular atrophy and hereditary spastic paraplegia- were included for analysis as MNDs. We measured age-standardized incidence, prevalence, death, and disability-adjusted life-years (DALYs) in 204 countries and territories worldwide from 1990 to 2019 using spatial Bayesian analyses. The effects of age, sex, and the sociodemographic index (measures of income per capita, education, and fertility) on incidence, prevalence, death, and disability-adjusted life-years due to MNDs were explored. According to 2019 GBD estimates, there were ~268,673 [95% uncertainty interval (UI), 213,893–310,663] prevalent cases and 63,700 (95% UI, 57,295–71,343) incident cases of MND worldwide. In 2019, MND caused 1,034,606 (95% UI, 979,910–1,085,401) DALYs and 39,081 (95% UI, 36,566–41,129) deaths worldwide. The age-standardized rates of prevalence, incidence, death, and DALYs for MNDs in 2019 were 3.37 (95% UI, 2.9–3.87) per 100,000 people, 0.79 (95% UI, 0.72–0.88) per 100,000 people, 0.48 (95% UI, 0.45–0.51) per 100,000 people, and 12.66 (95% UI, 11.98–13.29) per 100,000 people, respectively. The global prevalence and deaths due to MND in 2019 were increased (1.91% [95% UI, 0.61–3.42] and 12.39% [95% UI, 5.81–19.27], respectively) compared to 1990, without significant change in incidence. More than half of the prevalence and deaths due to MND occurred in three high-income regions (North America, Western Europe, and Australasia). In most cases, the prevalence, incidence, and DALYs of MNDs were high in regions with high sociodemographic index; however, in high-income East Asia, these were relatively low compared to similar sociodemographic index groups elsewhere. The burden of MND increased between 1990 and 2019. Its expected increase in the future highlights the importance of global and national healthcare planning using more objective evidence. Geographical heterogeneity in the MND burden might suggest the influences of sociodemographic status and genetic background in various regions.</p

sj-docx-1-msj-10.1177_13524585221109397 – Supplemental material for A disproportionality analysis for the association of central nervous system demyelinating diseases with COVID-19 vaccination using the World Health Organization pharmacovigilance database

Supplemental material, sj-docx-1-msj-10.1177_13524585221109397 for A disproportionality analysis for the association of central nervous system demyelinating diseases with COVID-19 vaccination using the World Health Organization pharmacovigilance database by Jee-Eun Kim, Jin Park and Tae-Jin Song in Multiple Sclerosis Journal</p

Basal serum levels of cholesterol (A), low-density lipoprotein (B), LDL/HDL ratio (C), glucose (D), and mean daily dietary intake (E), and average weight (F).

<p>The left panels show the combined value for ALS mice of all age (Tg, n = 30) and the control mice (Wt). The right panels show the values for the ALS mice and controls in each age group. (n = 10, for each group) Values in the boxes and whisker plots are median values and interquatile ranges respectively. LDL: low-density lipoprotein, HDL: high-density lipoprotein. * <i>p</i><0.05.</p

Basal serum levels of cholesterol (A), low-density lipoprotein (B), and glucose (C) according to sex in ALS mice of all age (Tg) groups (n = 15, for each group) and age- and sex-matched controls (Wt).

<p>The basal serum cholesterol and low-density lipoprotein were significantly lower in male ALS mice compared with control mice. Values in the boxes and whisker plots are median values and interquatile ranges respectively. LDL: low-density lipoprotein, HDL: high-density lipoprotein. * <i>p</i><0.05.</p

The basal serum levels of cholesterol (A) and low-density lipoprotein (B) in female (left panel) and male (right panel) pre-symptomatic ALS (Tg, aged 60 days) and control (Wt) mice.

<p>(n = 5, for each group) The basal serum cholesterol and low-density lipoprotein levels were significantly lower in male (right panel), but not in female ALS mice (left ) compared with control mice. Values in the boxes and whisker plots are median values and interquatile ranges respectively. LDL: low-density lipoprotein. * <i>p</i><0.05.</p

Table_1_Guillain–Barré Syndrome and Variants Following COVID-19 Vaccination: Report of 13 Cases.DOCX

BackgroundAmidst growing concern about an increased risk of Guillain–Barré syndrome (GBS) following COVID-19 vaccination, clinical and electrodiagnostic features have not been fully characterized.MethodsWe retrospectively reviewed medical records of the patients diagnosed with GBS and its variants following COVID-19 vaccination at four referral hospitals during the period of the mass vaccination program in South Korea (February to October 2021).ResultsWe identified 13 patients with GBS and variants post COVID-19 vaccination: AstraZeneca vaccine (Vaxzevria) in 8, and Pfizer-BioNTech vaccine (Comirnaty) in 5. The mean time interval from vaccination to symptom onset was 15.6 days (range 4–30 days). Electrodiagnostic classification was demyelinating in 7, axonal in 4 and normal in 2 cases. Clinical manifestations were diverse with varying severity: classical GBS in 8 cases, paraparetic variant in 3, Miller-Fisher syndrome in 1 and acute cervicobrachial weakness in 1. Four patients developed respiratory failure, and 2 of them showed treatment-related fluctuations.ConclusionOur observations suggest that COVID-19 vaccines may be associated with GBS of distinctive clinical features characterized by severe quadriplegia, disproportionately frequent bilateral facial palsy or atypical incomplete variants. Continuous surveillance and further studies using robust study designs are warranted to fully assess the significance of the association.</p

Antibody profiles for MuSK, LRP4, and clustered AChR in patients with MG seronegative for AChR antibody on radioimmunoprecipitation assay.

<p>LEMS, Lambert-Eaton myasthenic syndrome; MND, motor neuron disease; MG, myasthenia gravis; MuSK, muscle-specific tyrosine kinase; CBA, cell-based assay; RIPA, radioimmunoprecipitation assay; LRP4, low-density lipoprotein receptor-related protein 4; cAChR, clustered acetylcholine receptor.</p

Myasthenia gravis seronegative for acetylcholine receptor antibodies in South Korea: Autoantibody profiles and clinical features - Fig 2

Results of CBA for antibodies to MuSK, LRP4, and clustered AChR (A) and correlation between CBA scores and RIA values for anti-MuSK antibodies (B) MuSK, muscle-specific tyrosine kinase; CBA, cell-based assay; LRP4, low-density lipoprotein receptor-related protein 4; AChR, acetylcholine receptor; RIA, radioimmunoassay.</p