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Characteristics of recurrence in area postrema-onset NMO spectrum disorder - a retrospective cohort study.
Zhang, Xianxing; Wu, Jin; Lin, Jingyu; Lin, Shifang; Lin, Aiyu.
Afiliación
  • Zhang X; Department of Neurology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350005, China.
  • Wu J; Fujian Key Laboratory of Molecular Neurology, Institute of Neuroscience, Fujian Medical University, Fuzhou, Fujian, 350004, China.
  • Lin J; Department of Neurology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350212, China.
  • Lin S; Department of Inspection four, Fujian Center for Drug Inspection and Fujian Center for Vaccine Inspection, Fuzhou, Fujian, 350004, China.
  • Lin A; Department of Neurology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350005, China.
BMC Neurol ; 24(1): 165, 2024 May 21.
Article en En | MEDLINE | ID: mdl-38773402
ABSTRACT

BACKGROUND:

Neuromyelitis Optica Spectrum Disorder (NMOSD) is an inflammatory autoimmune disease with high risk of recurrence and disability, the treatment goal is a recurrence free state. Area postrema (AP) is one of the most common involved area of NMOSD, which may have a particular significance in the pathogenesis of NMOSD and clinical heterogeneity. Our study is to investigate the clinical and recurrent characteristics AP onset NMOSD patients.

METHODS:

A retrospective study was done in a cohort of 166 AQP4-IgG seropositive NMOSD patients which were identified by the 2015 IPND criteria. The patients were divided into AP onset (APO-NMOSD) group and non-AP onset (NAPO-NMOSD) group based on the initial episode location. Clinical features and recurrence differences of two groups were compared.

RESULTS:

The APO-NMOSD group and NAPO-NMOSD group had a population ratio of 24142. APO-NMOSD patients were younger (34.6y VS 42.3y, P = 0.013), had lower EDSS at first episode (0.7 VS 4.2, p = 0.028) and last follow up (1.9 VS 3.3, p = 0.001), more likely to have multi-core lesions at the first attack (33.3% VS 9.2%, P = 0.001). Also, they had a higher annual recurrence rate (0.4 ± 0.28 VS 0.19 ± 0.25, P = 0.012). In natural course NMOSD patients without immunotherapy, APO-NMSOD had a shorter time of first relapse (P < 0.001) and higher annual recurrence rate (0.31 ± 0.22 VS 0.16 ± 0.26, P = 0.038) than NAPO-NMOSD. APO-NMOSD group also have a higher risk of having the first relapsing compared to optic neuritis onset-NMOSD (HR 2.641, 95% CI 1.427-4.887, p = 0.002) and myelitis onset-NMOSD group (HR 3.593, 95% CI 1.736-7.438, p = 0.001). Compared to NAPO-NMOSD, APO-NMOSD has a higher likelihood of brainstem recurrence (28.6% vs. 4.7%, p<0.001) during the first recurrence, while NAPO-NMOSD is more susceptible to optic nerve involvement (10.7% vs. 41.1%, p = 0.01).

CONCLUSION:

AQP4-IgG seropositive NMOSD patients with AP onset are youngers and have higher risk of recurrence. Clinicians should pay attention to AP damage in NMOSD, as it indicates a potential risk of recurrence. TRIAL REGISTRATION Retrospectively registered.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Recurrencia / Neuromielitis Óptica / Área Postrema Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: BMC Neurol Asunto de la revista: NEUROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Recurrencia / Neuromielitis Óptica / Área Postrema Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: BMC Neurol Asunto de la revista: NEUROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido