BMC Neurology (Mar 2025)

Acute neuromyelitis optica spectrum disorder patients’ clinical analysis of disability-related biomarkers

  • Xingyue Zheng,
  • Hongjing Yan,
  • Hao Yin,
  • Jing Shi,
  • Yuanyuan Liu,
  • Haotian Zhao,
  • Yuzhi Li,
  • Huakun Liu,
  • Lei Zhang,
  • Zhongrui Yan,
  • Chunbo Dong

DOI
https://doi.org/10.1186/s12883-025-04086-8
Journal volume & issue
Vol. 25, no. 1
pp. 1 – 11

Abstract

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Abstract Background The clinical features of neuromyelitis optica spectrum disorder (NMOSD) predominantly include optic neuritis and myelitis, among other symptoms. A greater level of disability during the acute phase typically suggests an unfavorable prognosis. Nevertheless, the clinical biomarkers that impact the severity of disability in NMOSD remain unclear. Methods We analyzed 41 NMOSD patients and 41 normal controls to identify biomarkers associated with the disease. NMOSD patients were categorized into two groups based on their Expanded Disability Status Scale(EDSS) score: mild to moderate disability (EDSS < 4) and severe disability (EDSS ≥ 4). Correlation and ROC analyses were conducted on various biomarkers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio(MLR), cerebrospinal fluid (CSF)/serum albumin quotient(QAlb), CSF/blood immunoglobulin G quotient (QIgG), CSF/blood immunoglobulin A quotient (QIgA), CSF/blood immunoglobulin M quotient (QIgM), to identify markers linked to disability severity and confirm their independence. Results Significant differences in blood NLR, PLR, and MLR were found between NMOSD patients and normal controls (P < 0.01) in biomarker comparison analysis. Significant variations in QAlb, QIgG, QIgA, QIgM, and PLR were noted between the two groups of NMOSD patients stratified by disability severity. A correlation analysis revealed a positive association between QAlb, QIgG, QIgA, QIgM, PLR, and EDSS scores. Levels of QAlb, QIgG, QIgA, QIgM, and PLR were found to be effective indicators of NMOSD severity in Receiver Operating Characteristic (ROC) analysis (P < 0.01). Multifactor regression analysis confirmed the independence of PLR in assessing disease severity (P < 0.01). Conclusion 1. QAlb, QIgG, QIgA, QIgM, and PLR have demonstrated efficacy as biomarkers for assessing the severity of NMOSD; 2. PLR has shown promise as a standalone indicator for evaluating disease severity in patients with NMOSD.

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