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Relapse Patterns in NMOSD: Evidence for Earlier Occurrence of Optic Neuritis and Possible Seasonal Variation.
Front Neurol. 2020; 11:537.FN

Abstract

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.

Authors+Show Affiliations

Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia.Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia.Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia.Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia.Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia.Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia.Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia.Division of Immunology, HSQ Pathology Queensland Central Laboratory, Herston, QLD, Australia.Nuffield Department of Clinical Neurosciences, John Radcliffe Infirmary, University of Oxford, Oxford, United Kingdom.Department of Immunopathology, Westmead Hospital, Westmead, NSW, Australia.School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, WA, Australia.Department of Neurology, Wellington Hospital, Newtown, United Kingdom.Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia.Department of Neurology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia.Department of Neurology, Townsville University Hospital, Douglas, QLD, Australia.Department of Neurology, Royal Adelaide Hospital, Adelaide, SA, Australia.Peter Duncan Neurosciences Unit, Centre for Applied Medical Research and Department of Neurology, St Vincent's Hospital, University of New South Wales, Darlinghurst, NSW, Australia.Institute of Health Biomedical Innovation, Translational Research Institute, Queensland University of Technology, Woolloongabba, QLD, Australia.Department of Neurology, Auckland City Hospital, Grafton, New Zealand.Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia.Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, Queen Elizabeth II Medical Centre, University of Western Australia, Nedlands, WA, Australia.Flinders Medical Centre, Flinders University, Bedford Park, SA, Australia.School of Medicine, Royal Brisbane and Women's Hospital, University of Queensland, Herston, QLD, Australia.Westmead Clinical School, Westmead Hospital, University of Sydney, Westmead, NSW, Australia.Department of Neurology, Canberra Hospital, Garran, ACT, Australia.Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, Queen Elizabeth II Medical Centre, University of Western Australia, Nedlands, WA, Australia.Sydney Medical School, Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW, Australia.Division of Immunology, HSQ Pathology Queensland Central Laboratory, Herston, QLD, Australia.Sydney Medical School, Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW, Australia.Westmead Clinical School, Westmead Hospital, University of Sydney, Westmead, NSW, Australia.Department of Neurology, Westmead Hospital, Westmead, NSW, Australia.Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia.South Western Sydney Medical School, Liverpool Hospital, University of New South Wales, Liverpool, NSW, Australia.Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia.Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, Australia.Department of Neurology, Royal Adelaide Hospital, Adelaide, SA, Australia.School of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia.Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW, Australia.Sydney Medical School, Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW, Australia.School of Medicine, University of Auckland, Grafton, New Zealand.Department of Neurology, Austin Health, Heidelberg, VIC, Australia.Department of Neurology, Christchurch Hospital, Christchurch, New Zealand.Centre for Clinical Research, Royal Brisbane and Women's Hospital, University of Queensland, Herston, QLD, Australia.School of Medicine, University of Auckland, Grafton, New Zealand.Department of Neurology, Westmead Hospital, Westmead, NSW, Australia.Brain Autoimmunity Group, Institute for Neuroscience and Muscle Research, The Kids Research Institute at the Children's Hospital, Westmead, NSW, Australia.Brain and Mind Research Institute, University of Sydney, Camperdown, NSW, Australia.School of Medicine, Deakin University, Waurn Ponds, VIC, Australia.Sydney Medical School, Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW, Australia.Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.Department of Neurology, St Vincent's Hospital, Darlinghurst, NSW, Australia.Westmead Clinical School, Westmead Hospital, University of Sydney, Westmead, NSW, Australia.Department of Neurology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia.Division of Immunology, HSQ Pathology Queensland Central Laboratory, Herston, QLD, Australia.School of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia.Brain and Mind Research Institute, University of Sydney, Camperdown, NSW, Australia.Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, Queen Elizabeth II Medical Centre, University of Western Australia, Nedlands, WA, Australia.Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, Australia.Sydney Medical School, Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW, Australia.Flinders Medical Centre, Flinders University, Bedford Park, SA, Australia.Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.Department of Neurology, Auckland City Hospital, Grafton, New Zealand.Brain Autoimmunity Group, Institute for Neuroscience and Muscle Research, The Kids Research Institute at the Children's Hospital, Westmead, NSW, Australia.Nuffield Department of Clinical Neurosciences, John Radcliffe Infirmary, University of Oxford, Oxford, United Kingdom.Nuffield Department of Clinical Neurosciences, John Radcliffe Infirmary, University of Oxford, Oxford, United Kingdom.Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32612571

Citation

Khalilidehkordi, Elham, et al. "Relapse Patterns in NMOSD: Evidence for Earlier Occurrence of Optic Neuritis and Possible Seasonal Variation." Frontiers in Neurology, vol. 11, 2020, p. 537.
Khalilidehkordi E, Clarke L, Arnett S, et al. Relapse Patterns in NMOSD: Evidence for Earlier Occurrence of Optic Neuritis and Possible Seasonal Variation. Front Neurol. 2020;11:537.
Khalilidehkordi, E., Clarke, L., Arnett, S., Bukhari, W., Jimenez Sanchez, S., O'Gorman, C., Sun, J., Prain, K. M., Woodhall, M., Silvestrini, R., Bundell, C. S., Abernethy, D., Bhuta, S., Blum, S., Boggild, M., Boundy, K., Brew, B. J., Brown, M., Brownlee, W., ... Broadley, S. A. (2020). Relapse Patterns in NMOSD: Evidence for Earlier Occurrence of Optic Neuritis and Possible Seasonal Variation. Frontiers in Neurology, 11, 537. https://doi.org/10.3389/fneur.2020.00537
Khalilidehkordi E, et al. Relapse Patterns in NMOSD: Evidence for Earlier Occurrence of Optic Neuritis and Possible Seasonal Variation. Front Neurol. 2020;11:537. PubMed PMID: 32612571.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relapse Patterns in NMOSD: Evidence for Earlier Occurrence of Optic Neuritis and Possible Seasonal Variation. AU - Khalilidehkordi,Elham, AU - Clarke,Laura, AU - Arnett,Simon, AU - Bukhari,Wajih, AU - Jimenez Sanchez,Sofia, AU - O'Gorman,Cullen, AU - Sun,Jing, AU - Prain,Kerri M, AU - Woodhall,Mark, AU - Silvestrini,Roger, AU - Bundell,Christine S, AU - Abernethy,David, AU - Bhuta,Sandeep, AU - Blum,Stefan, AU - Boggild,Mike, AU - Boundy,Karyn, AU - Brew,Bruce J, AU - Brown,Matthew, AU - Brownlee,Wallace, AU - Butzkueven,Helmut, AU - Carroll,William M, AU - Chen,Celia, AU - Coulthard,Alan, AU - Dale,Russell C, AU - Das,Chandi, AU - Fabis-Pedrini,Marzena J, AU - Fulcher,David, AU - Gillis,David, AU - Hawke,Simon, AU - Heard,Robert, AU - Henderson,Andrew P D, AU - Heshmat,Saman, AU - Hodgkinson,Suzanne, AU - Kilpatrick,Trevor J, AU - King,John, AU - Kneebone,Chris, AU - Kornberg,Andrew J, AU - Lechner-Scott,Jeannette, AU - Lin,Ming-Wei, AU - Lynch,Christopher, AU - Macdonell,Richard A L, AU - Mason,Deborah F, AU - McCombe,Pamela A, AU - Pereira,Jennifer, AU - Pollard,John D, AU - Ramanathan,Sudarshini, AU - Reddel,Stephen W, AU - Shaw,Cameron, AU - Spies,Judith, AU - Stankovich,James, AU - Sutton,Ian, AU - Vucic,Steve, AU - Walsh,Michael, AU - Wong,Richard C, AU - Yiu,Eppie M, AU - Barnett,Michael H, AU - Kermode,Allan G, AU - Marriott,Mark P, AU - Parratt,John, AU - Slee,Mark, AU - Taylor,Bruce V, AU - Willoughby,Ernest, AU - Brilot,Fabienne, AU - Vincent,Angela, AU - Waters,Patrick, AU - Broadley,Simon A, Y1 - 2020/06/16/ PY - 2020/03/12/received PY - 2020/05/14/accepted PY - 2020/7/3/entrez PY - 2020/7/3/pubmed PY - 2020/7/3/medline KW - aquaporin KW - epidemiology KW - multiple sclerosis KW - neuromyelitis optica KW - relapse KW - seasonality SP - 537 EP - 537 JF - Frontiers in neurology JO - Front Neurol VL - 11 N2 - 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. SN - 1664-2295 UR - https://www.unboundmedicine.com/medline/citation/32612571/Relapse_Patterns_in_NMOSD:_Evidence_for_Earlier_Occurrence_of_Optic_Neuritis_and_Possible_Seasonal_Variation L2 - https://doi.org/10.3389/fneur.2020.00537 DB - PRIME DP - Unbound Medicine ER -
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