Relapse Patterns in NMOSD: Evidence for Earlier Occurrence of Optic Neuritis and Possible Seasonal Variation.

2020

Khalilidehkordi, Elham

Clarke, Laura

Arnett, Simon

Bukhari, Wajih

Jimenez Sanchez, Sofia

O'Gorman, Cullen

Sun, Jing

Prain, Kerri M

Woodhall, Mark

Silvestrini, Roger

Bundell, Christine S

Abernethy, David

Bhuta, Sandeep

Blum, Stefan

Boggild, Mike

Boundy, Karyn

Brew, Bruce J

Brown, Matthew

Brownlee, Wallace

Butzkueven, Helmut

Carroll, William M

Chen, Celia

Coulthard, Alan

Dale, Russell C

Das, Chandi

Fabis-Pedrini, Marzena J

Fulcher, David

Gillis, David

Hawke, Simon

Heard, Robert

Henderson, Andrew P D

Heshmat, Saman

Hodgkinson, Suzanne

Kilpatrick, Trevor J

King, John

Kneebone, Chris

Kornberg, Andrew J

Lechner-Scott, Jeannette

Lin, Ming-Wei

Lynch, Christopher

Macdonell, Richard A L

Mason, Deborah F

McCombe, Pamela A

Pereira, Jennifer

Pollard, John D

Ramanathan, Sudarshini

Reddel, Stephen W

Shaw, Cameron

Spies, Judith

Stankovich, James

Sutton, Ian

Vucic, Steve

Walsh, Michael

Wong, Richard C

Yiu, Eppie M

Barnett, Michael H

Kermode, Allan G

Marriott, Mark P

Parratt, John

Slee, Mark

Taylor, Bruce V

Willoughby, Ernest

Brilot, Fabienne

Vincent, Angela

Waters, Patrick

Broadley, Simon A

aquaporin

epidemiology

multiple sclerosis

neuromyelitis optica

relapse

seasonality

Journal Article

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.

link

Frontiers in neurology 2020; 11: 537

Frontiers in neurology

1664-2295