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


Khalilidehkordi, E and Clarke, L and Arnett, S and Bukhari, W and Jimenez Sanchez, S and O'Gorman, C and Sun, J and Prain, KM and Woodhall, M and Silvestrini, R and Bundell, CS and Abernethy, D and Bhuta, S and Blum, S and Boggild, M and Boundy, K and Brew, BJ and Brown, M and Brownlee, W and Butzkueven, H and Carroll, WM and Chen, C and Coulthard, A and Dale, RC and Das, C and Fabis-Pedrini, MJ and Fulcher, D and Gillis, D and Hawke, S and Heard, R and Henderson, APD and Heshmat, S and Hodgkinson, S and Kilpatrick, TJ and King, J and Kneebone, C and Kornberg, AJ and Lechner-Scott, J and Lin, M-W and Lynch, C and Macdonell, RAL and Mason, DF and McCombe, PA and Pereira, J and Pollard, JD and Ramanathan, S and Reddel, SW and Shaw, C and Spies, J and Stankovich, J and Sutton, I and Vucic, S and Walsh, M and Wong, RC and Yiu, EM and Barnett, MH and Kermode, AG and Marriott, MP and Parratt, J and Slee, M and Taylor, BV and Willoughby, E and Brilot, F and Vincent, A and Waters, P and Broadley, SA, Relapse patterns in NMOSD: evidence for earlier occurrence of optic neuritis and possible seasonal variation, Frontiers in Neurology, 11 Article 537. ISSN 1664-2295 (2020) [Refereed Article]

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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.

DOI: doi:10.3389/fneur.2020.00537


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.

Item Details

Item Type:Refereed Article
Keywords:aquaporin, epidemiology, multiple sclerosis, neuromyelitis optica, relapse, seasonality
Research Division:Biomedical and Clinical Sciences
Research Group:Neurosciences
Research Field:Central nervous system
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Stankovich, J (Dr Jim Stankovich)
UTAS Author:Taylor, BV (Professor Bruce Taylor)
ID Code:140289
Year Published:2020
Web of Science® Times Cited:17
Deposited By:Menzies Institute for Medical Research
Deposited On:2020-08-05
Last Modified:2022-08-23
Downloads:16 View Download Statistics

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