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Relapse patterns in NMOSD: evidence for earlier occurrence of optic neuritis and possible seasonal variation

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posted on 2023-05-20, 16:43 authored by Khalilidehkordi, E, Clarke, L, Arnett, S, Bukhari, W, Jimenez Sanchez, S, O'Gorman, C, Sun, J, Prain, KM, Woodhall, M, Silvestrini, R, Bundell, CS, Abernethy, D, Bhuta, S, Blum, S, Boggild, M, Boundy, K, Brew, BJ, Brown, M, Brownlee, W, Butzkueven, H, Carroll, WM, Chen, C, Coulthard, A, Dale, RC, Das, C, Fabis-Pedrini, MJ, Fulcher, D, Gillis, D, Hawke, S, Heard, R, Henderson, APD, Heshmat, S, Hodgkinson, S, Kilpatrick, TJ, King, J, Kneebone, C, Kornberg, AJ, Lechner-Scott, J, Lin, M-W, Lynch, C, Macdonell, RAL, Mason, DF, McCombe, PA, Pereira, J, Pollard, JD, Ramanathan, S, Reddel, SW, Shaw, C, Spies, J, Jim Stankovich, Sutton, I, Vucic, S, Walsh, M, Wong, RC, Yiu, EM, Barnett, MH, Kermode, AG, Marriott, MP, Parratt, J, Slee, M, Bruce TaylorBruce Taylor, Willoughby, E, Brilot, F, Vincent, A, Waters, P, Broadley, SA
Neuromyelitis optica spectrum disorders (NMOSD) and multiple sclerosis (MS) show overlap in their clinical features. We performed an analysis of relapses with the aim of determining differences between the two conditions. Cases of NMOSD and age- and sex-matched MS controls were collected from across Australia and New Zealand. Demographic and clinical information, including relapse histories, were recorded using a standard questionnaire. There were 75 cases of NMOSD and 101 MS controls. There were 328 relapses in the NMOSD cases and 375 in MS controls. Spinal cord and optic neuritis attacks were the most common relapses in both NMOSD and MS. Optic neuritis (p < 0.001) and area postrema relapses (P = 0.002) were more common in NMOSD and other brainstem attacks were more common in MS (p < 0.001). Prior to age 30 years, attacks of optic neuritis were more common in NMOSD than transverse myelitis. After 30 this pattern was reversed. Relapses in NMOSD were more likely to be treated with acute immunotherapies and were less likely to recover completely. Analysis by month of relapse in NMOSD showed a trend toward reduced risk of relapse in February to April compared to a peak in November to January (P = 0.065). Optic neuritis and transverse myelitis are the most common types of relapse in NMOSD and MS. Optic neuritis tends to occur more frequently in NMOSD prior to the age of 30, with transverse myelitis being more common thereafter. Relapses in NMOSD were more severe. A seasonal bias for relapses in spring-summer may exist in NMOSD.

History

Publication title

Frontiers in Neurology

Volume

11

Article number

537

Number

537

Pagination

1-8

ISSN

1664-2295

Department/School

Menzies Institute for Medical Research

Publisher

Frontiers Research Foundation

Place of publication

Switzerland

Rights statement

Copyright © 2020 the authors. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) License. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Clinical health not elsewhere classified

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