Frontiers in Neurology (Jun 2020)
Relapse Patterns in NMOSD: Evidence for Earlier Occurrence of Optic Neuritis and Possible Seasonal Variation
- Elham Khalilidehkordi,
- Laura Clarke,
- Simon Arnett,
- Wajih Bukhari,
- Sofia Jimenez Sanchez,
- Cullen O'Gorman,
- Jing Sun,
- Kerri M. Prain,
- Mark Woodhall,
- Roger Silvestrini,
- Christine S. Bundell,
- David Abernethy,
- Sandeep Bhuta,
- Stefan Blum,
- Mike Boggild,
- Karyn Boundy,
- Bruce J. Brew,
- Matthew Brown,
- Wallace Brownlee,
- Helmut Butzkueven,
- William M. Carroll,
- Celia Chen,
- Alan Coulthard,
- Russell C. Dale,
- Chandi Das,
- Marzena J. Fabis-Pedrini,
- David Fulcher,
- David Gillis,
- Simon Hawke,
- Robert Heard,
- Andrew P. D. Henderson,
- Saman Heshmat,
- Suzanne Hodgkinson,
- Trevor J. Kilpatrick,
- John King,
- Chris Kneebone,
- Andrew J. Kornberg,
- Jeannette Lechner-Scott,
- Ming-Wei Lin,
- Christopher Lynch,
- Richard A. L. Macdonell,
- Deborah F. Mason,
- Pamela A. McCombe,
- Jennifer Pereira,
- John D. Pollard,
- Sudarshini Ramanathan,
- Stephen W. Reddel,
- Cameron Shaw,
- Judith Spies,
- James Stankovich,
- Ian Sutton,
- Steve Vucic,
- Michael Walsh,
- Richard C. Wong,
- Eppie M. Yiu,
- Michael H. Barnett,
- Allan G. Kermode,
- Mark P. Marriott,
- John Parratt,
- Mark Slee,
- Bruce V. Taylor,
- Ernest Willoughby,
- Fabienne Brilot,
- Angela Vincent,
- Patrick Waters,
- Simon A. Broadley
Affiliations
- Elham Khalilidehkordi
- Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia
- Laura Clarke
- Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia
- Simon Arnett
- Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia
- Wajih Bukhari
- Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia
- Sofia Jimenez Sanchez
- Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia
- Cullen O'Gorman
- Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia
- Jing Sun
- Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia
- Kerri M. Prain
- Division of Immunology, HSQ Pathology Queensland Central Laboratory, Herston, QLD, Australia
- Mark Woodhall
- Nuffield Department of Clinical Neurosciences, John Radcliffe Infirmary, University of Oxford, Oxford, United Kingdom
- Roger Silvestrini
- Department of Immunopathology, Westmead Hospital, Westmead, NSW, Australia
- Christine S. Bundell
- School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, WA, Australia
- David Abernethy
- Department of Neurology, Wellington Hospital, Newtown, United Kingdom
- Sandeep Bhuta
- Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia
- Stefan Blum
- Department of Neurology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
- Mike Boggild
- Department of Neurology, Townsville University Hospital, Douglas, QLD, Australia
- Karyn Boundy
- Department of Neurology, Royal Adelaide Hospital, Adelaide, SA, Australia
- Bruce J. Brew
- 0Peter Duncan Neurosciences Unit, Centre for Applied Medical Research and Department of Neurology, St Vincent's Hospital, University of New South Wales, Darlinghurst, NSW, Australia
- Matthew Brown
- 1Institute of Health Biomedical Innovation, Translational Research Institute, Queensland University of Technology, Woolloongabba, QLD, Australia
- Wallace Brownlee
- 2Department of Neurology, Auckland City Hospital, Grafton, New Zealand
- Helmut Butzkueven
- 3Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- William M. Carroll
- 4Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, Queen Elizabeth II Medical Centre, University of Western Australia, Nedlands, WA, Australia
- Celia Chen
- 5Flinders Medical Centre, Flinders University, Bedford Park, SA, Australia
- Alan Coulthard
- 6School of Medicine, Royal Brisbane and Women's Hospital, University of Queensland, Herston, QLD, Australia
- Russell C. Dale
- 7Westmead Clinical School, Westmead Hospital, University of Sydney, Westmead, NSW, Australia
- Chandi Das
- 8Department of Neurology, Canberra Hospital, Garran, ACT, Australia
- Marzena J. Fabis-Pedrini
- 4Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, Queen Elizabeth II Medical Centre, University of Western Australia, Nedlands, WA, Australia
- David Fulcher
- 9Sydney Medical School, Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW, Australia
- David Gillis
- Division of Immunology, HSQ Pathology Queensland Central Laboratory, Herston, QLD, Australia
- Simon Hawke
- 9Sydney Medical School, Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW, Australia
- Robert Heard
- 7Westmead Clinical School, Westmead Hospital, University of Sydney, Westmead, NSW, Australia
- Andrew P. D. Henderson
- 0Department of Neurology, Westmead Hospital, Westmead, NSW, Australia
- Saman Heshmat
- Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia
- Suzanne Hodgkinson
- 1South Western Sydney Medical School, Liverpool Hospital, University of New South Wales, Liverpool, NSW, Australia
- Trevor J. Kilpatrick
- 2Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
- John King
- 3Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, Australia
- Chris Kneebone
- Department of Neurology, Royal Adelaide Hospital, Adelaide, SA, Australia
- Andrew J. Kornberg
- 4School of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
- Jeannette Lechner-Scott
- 5Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW, Australia
- Ming-Wei Lin
- 9Sydney Medical School, Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW, Australia
- Christopher Lynch
- 6School of Medicine, University of Auckland, Grafton, New Zealand
- Richard A. L. Macdonell
- 7Department of Neurology, Austin Health, Heidelberg, VIC, Australia
- Deborah F. Mason
- 8Department of Neurology, Christchurch Hospital, Christchurch, New Zealand
- Pamela A. McCombe
- 9Centre for Clinical Research, Royal Brisbane and Women's Hospital, University of Queensland, Herston, QLD, Australia
- Jennifer Pereira
- 6School of Medicine, University of Auckland, Grafton, New Zealand
- John D. Pollard
- 0Department of Neurology, Westmead Hospital, Westmead, NSW, Australia
- Sudarshini Ramanathan
- 0Brain Autoimmunity Group, Institute for Neuroscience and Muscle Research, The Kids Research Institute at the Children's Hospital, Westmead, NSW, Australia
- Stephen W. Reddel
- 1Brain and Mind Research Institute, University of Sydney, Camperdown, NSW, Australia
- Cameron Shaw
- 2School of Medicine, Deakin University, Waurn Ponds, VIC, Australia
- Judith Spies
- 9Sydney Medical School, Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW, Australia
- James Stankovich
- 3Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
- Ian Sutton
- 4Department of Neurology, St Vincent's Hospital, Darlinghurst, NSW, Australia
- Steve Vucic
- 7Westmead Clinical School, Westmead Hospital, University of Sydney, Westmead, NSW, Australia
- Michael Walsh
- Department of Neurology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
- Richard C. Wong
- Division of Immunology, HSQ Pathology Queensland Central Laboratory, Herston, QLD, Australia
- Eppie M. Yiu
- 4School of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
- Michael H. Barnett
- 1Brain and Mind Research Institute, University of Sydney, Camperdown, NSW, Australia
- Allan G. Kermode
- 4Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, Queen Elizabeth II Medical Centre, University of Western Australia, Nedlands, WA, Australia
- Mark P. Marriott
- 3Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, Australia
- John Parratt
- 9Sydney Medical School, Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW, Australia
- Mark Slee
- 5Flinders Medical Centre, Flinders University, Bedford Park, SA, Australia
- Bruce V. Taylor
- 3Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
- Ernest Willoughby
- 2Department of Neurology, Auckland City Hospital, Grafton, New Zealand
- Fabienne Brilot
- 0Brain Autoimmunity Group, Institute for Neuroscience and Muscle Research, The Kids Research Institute at the Children's Hospital, Westmead, NSW, Australia
- Angela Vincent
- Nuffield Department of Clinical Neurosciences, John Radcliffe Infirmary, University of Oxford, Oxford, United Kingdom
- Patrick Waters
- Nuffield Department of Clinical Neurosciences, John Radcliffe Infirmary, University of Oxford, Oxford, United Kingdom
- Simon A. Broadley
- Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD, Australia
- DOI
- https://doi.org/10.3389/fneur.2020.00537
- Journal volume & issue
-
Vol. 11
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.
Keywords
