Current symptomatology in multiple sclerosis and neuromyelitis optica

Area of Science:

• Neuroimmunology
• Central Nervous System Inflammatory Diseases
• Demyelinating Disorders

Background:

• Multiple Sclerosis (MS) and Neuromyelitis Optica Spectrum Disorder (NMOSD) are inflammatory central nervous system diseases.
• Some symptoms, such as Lhermitte's sign and Uhthoff's phenomenon, were historically considered characteristic of MS.
• A significant overlap exists, with opticospinal forms of MS often being reclassified as NMOSD.

Purpose of the Study:

• To investigate the frequency of MS-associated symptoms and signs in patients with NMOSD and MS.
• To identify clinical features that differentiate NMOSD from MS.

Main Methods:

• A comparative study of consecutive Japanese patients diagnosed with NMOSD (NMO or partial NMO) and MS.
• Data collected from patients seen at Chiba University Hospital between 2011 and 2012.
• Logistic regression analyses were employed to distinguish between NMOSD and MS based on symptom and sign frequencies.

Main Results:

• Univariate analysis indicated higher frequencies of tonic seizures, Lhermitte's sign, persistent pain, fatigue, and girdle sensation in NMOSD patients compared to MS patients.
• Multivariate logistic regression identified paroxysmal itching, Uhthoff's phenomenon, Lhermitte's sign, and girdle sensation as more characteristic of NMOSD than MS.

Conclusions:

• Certain classic MS symptoms are more prevalent in NMOSD patients.
• These differences may stem from variations in inflammatory severity, lesion localization, and extent in demyelinating diseases.
• Distinguishing clinical features can aid in differentiating NMOSD from MS.