Idiopathic inflammatory demyelinating diseases of the central nervous system are polysymptomatic at the initial presentation, concluded a new study published in the journal Cureus. Men with diabetes seem to be more prone to have progressive disorders.
To assess the incidence, presenting features, magnetic resonance imaging (MRI) findings, and predictors of disease progression of prevalent demyelinating disorders, a team of researchers conducted a prospective, observational study between August 2018 and November 2021 at Srirama Chandra Bhanja Medical College and Hospital.
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The team assessed 220 patients with common demyelinating disorders. The cohort was 18 to 65 years of age. They reported that the most common idiopathic inflammatory demyelinating disease was neuromyelitis optica spectrum disorder (NMOSD), affecting 39.5% of patients. This was followed by multiple sclerosis (MS), which affected 32.7% of patients. Other demyelinating disorders that were less common in the study population were acute transverse myelitis, affecting 15.9% of patients, and acute disseminated encephalomyelitis, affecting 11.8% of the patients.
Univariate analysis showed that male gender, the presence of diabetes mellitus, and a history of smoking or alcoholism were significant predictors of disease progression. However, multivariate analysis did not lead to statistically significant results.
“We warrant more extensive studies, including the immunological markers as predictors of treatment outcome and disease progression,” the researchers concluded.
NMOSD is a rare inflammatory disease mediated by the production of autoantibodies that damages the tissues of the central nervous system. The disease is mainly characterized by the inflammation of long segments of the spinal cord, also known as myelitis and severe optic neuritis. The majority of patients with the disease have autoantibodies against the aquaporin-4 water channel situated on astrocytes, which are essential for the survival and function of neurons.
Biswal NR, Mallick AK, Swain K, Sahoo JP. An observational study of multi-faceted demyelinating disorders. Cureus. Published online August 19, 2023. doi:10.7759/cureus.43775