Optica Spectrum Disorder Patients Research Articles

Altered Microstructure of Cerebral Gray Matter in Neuromyelitis Optica Spectrum Disorder-Optic Neuritis: A DKI Study.

The purpose of this study was to analyze microstructural alterations in cerebral gray matter using non-Gaussian diffusion kurtosis imaging (DKI) in neuromyelitis optica spectrum disorder (NMOSD) patients with optic neuritis (NMOSD-ON). DKI was performed in 14 NMOSD-ON patients and 22 normal controls (NCs). DKI-derived metrics, including mean kurtosis (MK), radial kurtosis (RK), axial kurtosis (AK), fractional anisotropy (FA), and mean diffusivity (MD), were voxel-wisely compared by two-sample t-tests with gaussian random field (GRF) correction between the two groups. The correlations between altered DKI metrics and clinical features were analyzed. Compared with NCs, NMOSD-ON patients showed significantly decreased MK and RK both in the left inferior temporal gyrus (ITG), and decreased AK in the bilateral calcarine (CAL). While increased MD in the left fusiform gyrus (FFG), right CAL, and right hippocampus (HIP)/parahippocampal gyrus (PHG) were found. Furthermore, correlation analysis showed that mean deviation was negatively correlated with AK values of bilateral CAL and positively correlated with MD values of right CAL (q < 0.05, false discovery rate (FDR) corrected). For NMOSD-ON patients, microstructural abnormalities in the occipital visual cortex are correlated with clinical disability. These findings may provide complementary information to understand the neuropathological mechanisms underlying the impairments of cerebral gray matter in NMOSD-ON.

A comparison of cognitive performances between neuromyelitis optica spectrum disorder and multiple sclerosis patients in Indian context

BackgroundTo compare the frequency and pattern of cognitive impairment in neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) patients.ResultsTwenty NMOSD and forty MS patients were included. Clinical and detailed neuropsychological assessment was done using frontal assessment battery and Kolkata cognitive battery supplemented with additional standard tests for different domains of cognitive functions. Domain wise tests were performed and compared. 15/20 (75%) NMOSD and 32/40 (80%) MS patients had cognitive impairment (p = 0.65). Executive function, verbal fluency, information processing speed, visuo-constructional ability, attention, complex calculation, and memory were more commonly involved in NMOSD in decreasing order. Compared to MS, the pattern was similar except that verbal fluency was more impaired in NMOSD. Expanded Disability Status scale (EDSS) correlated with cognitive involvement in NMOSD (p = 0.02) as against MS.ConclusionsExecutive function, verbal fluencies, and information processing speed were more affected compared to visual and verbal memory in NMOSD patients. The pattern of cognitive performance was similar in the MS group, even though clinical and radiological characteristics and pathophysiology is different, suggesting similar brain involvement.

PRO75 Demographics and Relapse Profile Correlates with Treatment Change in Neuromyelitis Optica Spectrum Disorder (NMOSD) Patients: Analysis of the Circles Study

PRO75 Demographics and Relapse Profile Correlates with Treatment Change in Neuromyelitis Optica Spectrum Disorder (NMOSD) Patients: Analysis of the Circles Study

Free thyroxine level is associated with both relapse rate and poor neurofunction in first-attack Neuromyelitis Optica Spectrum Disorder (NMOSD) patients

BackgroundTo investigate whether the serum free thyroxine (FT4) level is a prognostic factor for the first-attack neuromyelitis optica spectrum disorders (NMOSD).MethodsThis retrospective study enrolled 109 patients with first-attack NMOSD. The Expanded Disability Status Scale (EDSS) and the relapse rate were used to evaluate the outcomes. The logistic regression model was used to analyze the independent effects of FT4 on relapse and final EDSS. Kaplan-Meier analysis, scatter plot smoothing method, and two-phase piecewise linear regression model were used to investigate the relationship between the FT4 level and the relapse rate.ResultsMultivariate analysis revealed that serum FT4 level might be a risk factor for both final EDSS (β = 0.17; 95% confidence interval: 0.03–0.32) and the relapse rate (HR = 1.18; 95% confidence interval: 1.05–1.32). Furthermore, 1400 days after the onset, nearly 100% of patients in the high-FT4 group relapsed, while only 40% of the patients in the low-FT4 group relapsed. Finally, we found that the relationship between the FT4 level and the NMOSD relapse rate was nonlinear. The risk of NMOSD relapse increased with the FT4 level up to the inflection point of 12.01 pmol/L (HR = 1.45; 95% confidence interval: 1.06–1.98). When the FT4 level was > 12.01 pmol/L, there was no correlation between the FT4 level and the risk of NMOSD relapse (HR = 1.05; 95% confidence interval: 0.78–1.41).ConclusionSerum FT4 level may be a prognostic indicator for the first-attack in patients with NMOSD. High FT4 levels are associated with poor neurofunctions and a high relapse rate in patients with the first-attack in patients with NMOSD.

Therapeutic plasma exchange for neuromyelitis optica spectrum disorder: A multicenter retrospective study by the ASFA neurologic diseases subcommittee.

Neuromyelitis optica/neuromyelitis optica spectrum disorder patients' response to therapeutic plasma exchange (TPE) is currently incompletely characterized. Our study aims to understand the clinical status improvement of neuromyelitis optica/neuromyelitis optica spectrum disorder patients treated with TPE. This is a multicenter retrospective study conducted between 1 January 2003 and 31 July 2017 at 13 US hospitals performing apheresis procedures. Subjects studied were diagnosed with neuromyelitis optica/neuromyelitis optica spectrum disorder who received TPE during presentation with acute disease. The primary outcome was clinical status improvement in patients treated with TPE. Secondary measures were procedural and patient characteristics associated with response to treatment. We evaluated 114 patients from 13 institutions. There was a female predilection. The largest ethnic group affected was non-Hispanic Caucasian. The average age of diagnosis was 43.1 years. The average time to diagnosis was 3.1 years. On average, five procedures were performed during each treatment series. The most commonly performed plasma volume exchange was 1.0 to 1.25 using 5% albumin as replacement fluid. Most patients (52%) did not require an additional course of TPE and noted "mild" to "moderate" clinical status improvement. Maximal symptom improvement appeared by the fourth or fifth TPE treatment. TPE improved the clinical status of patients. Adults responded more favorably than children. Procedural characteristics, including number of TPEs, plasma volume exchanged, and replacement fluid used, were similar between institutions. TPE was well-tolerated and had a low severe adverse event profile.

Assessment of Coping Strategies in Neuromyelitis Optica Spectrum Disorder and Multiple Sclerosis Patients

Assessment of Coping Strategies in Neuromyelitis Optica Spectrum Disorder and Multiple Sclerosis Patients

Effects of early using azathioprine in the acute phase in neuromyelitis optica spectrum disorder

Background: Azathioprine is widely used for neuromyelitis optica spectrum disorder (NMOSD) patients, while a consensus of timing to receive azathioprine has not been proposed. Objective: The objective of this paper was to evaluate the efficacy of early access of azathioprine in NMOSD patients. Methods: We conducted a retrospective review of NMOSD patients based on medical records. Included patients were divided into three groups: group IVMT + AZA, group AZA after IVMT and group IVMT. Time to next relapse was adopted as the endpoint. Results: Patients from group IVMT + AZA had a longer duration of remission compared with patients from group AZA after IVMT ( p = 0.025) and group IVMT ( p < 0.001), and longer duration showed in the group AZA after IVMT when compared with group IVMT ( p = 0.005). We found that older age of initial attack was a risk factor for NMOSD patients (HR: 1.235; p = 0.022), and younger age of receiving treatment was a protect factor (HR: 0.804; p = 0.023). Partial patients have used azathioprine before this study in group IVMT + AZA, result showed there was no significance between the patients who had or had not used azathioprine ( p = 0.299). Conclusion: Azathioprine could prolong the duration of remission after treatment, especially given within two weeks after attack. Patients who received azathioprine combined with glucocorticoids had a preferable effect than glucocorticoids alone in the remission.