Comorbidities unrelated to the immune system may impact disease presentation in patients with neuromyelitis optica spectrum disorder (NMOSD), according to an article recently published in the Journal of Clinical Neuroscience.

“Comorbidities appear to be an important factor influencing disability in patients with NMOSD; therefore, comorbidity screening should be emphasized as part of patient care,” the authors wrote.

This retrospective study included 138 patients previously diagnosed with NMOSD and at least 1 comorbidity and 404 patients with NMOSD but no other comorbidity as the control group.

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Most comorbidities were related to the endocrine system (25.87%), followed by the circulatory system (24.38%), digestive system (15.42%), tumors and other comorbidities (8.96% each), nervous system (7.46%), infectious diseases (6.47%), and respiratory system (2.49%).

Notably, participants with comorbidities had significantly higher chances of suffering from relapses, which occurred in 68.5% of the cases in this group. On the other hand, 54.5% of the control group also experienced relapses.

Multifocal lesions in the central nervous system, severe vision attacks, and severe motor attacks presented more often among the participants with comorbidities in 30.4%, 28.3%, and 30.4% of the cases, respectively.

The patients without comorbidities showcased multifocal central nervous system lesions in 18.32%, severe vision attacks in 15.8%, and severe motor attacks in 11.9% of the cases. Also, those with comorbidities had a higher body mass index on average at 23.12 kg/m2 vs the control group at 22.04 kg/m2.

Patients with comorbidities also had a greater median age of onset older than those without, the researchers noted.

“In addition to immunotherapy, the management of comorbidities is vital, particularly in the intervention of modifiable lifestyle factors,” the study authors concluded.


Cai L, Chen H, Shi Z, et al. Non-immune system comorbidity in neuromyelitis optica spectrum disorders. J Clin Neurosci. Published online November 30, 2022. doi:10.1016/j.jocn.2022.11.008