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Article History

Received: 20 March 2026

Revised: 22 June 2026

Accepted: 26 June 2026

First Online: 26 July 2026

Declarations

Conflict of interest: Naga Pradyumna Kothapalli has no disclosures or conflicts of interest. Yong Guo has no disclosures or conflicts of interest. Nisa Vorasoot has no disclosures or conflicts of interest. Dean M Wingerchuk reports personal fees for consulting or advisory board participation from Biogen, Genentech, Horizon Pharmaceuticals, MedImmune, Mitsubishi Tanabe, Novartis, Reistone Biopharma, Bristol Myers Squibb, Imcyse, Merck Serono, Roche Pharmaceuticals, TTY Biopharm, Viela Bio, UCB Pharma, and Alexion; research support paid to the Mayo Clinic by Alexion; and payment for service on clinical trial adjudication committees for MedImmune, Viela Bio, and UCB Pharma. Dr Flanagan has served on Alexion, Genentech, Horizon Therapeutics and UCB advisory boards. He has received research support from UCB. He received royalties from UpToDate. Dr Flanagan is a site principal investigator in a randomized clinical trial of Rozanolixizumab for relapsing myelin oligodendrocyte glycoprotein antibody-associated disease run by UCB. Dr Flanagan is a site principal investigator and a member of the steering committee for a clinical trial of satralizumab for relapsing myelin oligodendrocyte glycoprotein antibody-associated disease run by Roche/Genentech. Dr Flanagan is a Co-Investigator on a study of ravulizumab for neuromyelitis optica spectrum disorder run by Alexion. Dr Flanagan has given educational talks on neuromyelitis optica spectrum disorder funded by Alexion. Dr Flanagan has received funding from the NIH (R01NS113828). Dr Flanagan has received honoraria for editing and writing articles for The Continuum Lifelong Learning in Neurology Journal which is a publication of the American Academy of Neurology. Dr Flanagan is a member of the medical advisory board of the MOG project and Sumaira Foundation. Dr Flanagan is an editorial board member of Neurology, Neuroimmunology and Neuroinflammation, The Journal of the Neurological Sciences and Neuroimmunology Reports. A patent has been submitted on DACH1-IgG as a biomarker of paraneoplastic autoimmunity. Divyanshu Dubey has consulted for UCB, Immunovant, Argenx, Arialys, and Astellas Pharmaceuticals. All compensation for consulting activities is paid directly to the Mayo Clinic. He has patents pending for KLHL11, LUZP4-IgG, and cavin-4-IgG as markers of neurological autoimmunity. Dr. Dubey has received funding from the DOD (CA210208, PR220430), David J. Tomassoni’s ALS Research Grant, and UCB. Nanthaya Tisavipat has no disclosures or conflicts of interest. Fernando X. Cuascut has participated in EMD Serono, Genentech, Novartis, Amgen, and TG Therapeutics boards. Hemali Patel has no disclosures or conflicts of interest. Claudia F Lucchinetti has no disclosures or conflicts of interest. Sean J. Pittock has grants, personal fees, and non-financial support from Alexion Pharmaceuticals; grants, personal fees, and non-financial support from MedImmune/Viela Bio; and personal fees for consulting from Genentech, Roche, UCB, and Astellas. He has two patents issued (8889102; application 12-678350; Neuromyelitis Optica Autoantibodies as a Marker for Neoplasia; and 9891219B2; application 12-573942; methods for Treating Neuromyelitis Optica [NMO] by Administration of Eculizumab to an individual that is Aquaporin-4 [AQP4]-IgG Autoantibody positive). Sean J. Pittock also has patents pending for IgGs to the following proteins as biomarkers of autoimmune neurological disorders: septin-5, Kelch-like protein 11, GFAP, PDE10A, and MAP1B.