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Published on: April 14, 2014
Neuromyelitis optica spectrum disorders with unevenly clustered attack occurrence
Tetsuya Akaishi1, Ichiro Nakashima2, Toshiyuki Takahashi2
1From the Department of Neurology (T.A., T.T., M.A.), Tohoku University School of Medicine, Sendai, Japan; Department of Education and Support for Regional Medicine (T.A., M.A., T.I.), Tohoku University Hospital, Sendai, Japan; Department of Neurology (I.N.), Tohoku Medical and Pharmaceutical University, Sendai, Japan; and Department of Neurology (T.T.), National Hospital Organization Yonezawa National Hospital, Yonezawa, Japan. t-akaishi@med.tohoku.ac.jp.
Neuromyelitis optica spectrum disorders (NMOSDs) patients experience distinct attack patterns: clustered, frequent relapses within 12 months, and nonclustered, infrequent relapses. Understanding these patterns aids in optimizing relapse prevention strategies for NMOSD.
Area of Science:
- Neuroimmunology
- Clinical Neurology
Background:
- Neuromyelitis optica spectrum disorders (NMOSD) are autoimmune diseases targeting the central nervous system.
- Anti-aquaporin-4 antibodies are key biomarkers for a significant subset of NMOSD patients.
Purpose of the Study:
- To characterize the clinical attack patterns in NMOSD patients with positive anti-aquaporin-4 antibodies.
- To analyze the timing and sequential nature of clinical attack types.
Main Methods:
- Retrospective analysis of clinical data from 69 NMOSD patients at a single university hospital.
- Collection of detailed information on clinical attack types, dates, and other clinical factors.
Main Results:
- Two distinct attack occurrence patterns were identified: "clustered" (within 12 months of the previous attack) and "nonclustered" (≥12 months after).
- During "clustered" periods, attacks often shared similar manifestations (e.g., optic neuritis, myelitis).
- During "nonclustered" periods, relapses were of random clinical types.
Conclusions:
- NMOSD patients exhibit alternating periods of "clustered" frequent attacks and "nonclustered" sparse relapses.
- About half of all relapses occurred within 12 months of the preceding attack.
- Distinguishing between "clustered" and "nonclustered" periods is crucial for tailoring relapse-preventive therapies in NMOSD.
