Of all central nervous system inflammatory demyelinating diseases (CNSIDDs), aquaporin 4-IgG positive neuromyelitis optica spectrum disorder (NMOSD) was the most common form in Thailand, according to a study published in Multiple Sclerosis and Related Disorders.

AQP4-IgG-positive NMOSD had a prevalence of 3.08 (1.76–5.38) per 100,000 persons, a value comparable to values published for East Asian populations in other countries, as well as the primarily Caucasian population of Olmsted County, Minnesota. Multiple sclerosis (MS) was the second most common with a prevalence of 0.77 (0.26–2.26) per 100,000 individuals. Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) was the third most common at 0.51 (0.14–1.87) per 100,000 persons.

The incidence rate of NMOSD was estimated to be 0.26 per 100,000 persons per year, which was similar to a previous incidence rate published for China. Using the incidence and prevalence data, the study estimated approximately 2038 cases of NMOSD were present in Thailand on December 31, 2021.

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“A nationwide CNSIDDs registry would better elaborate the epidemiology of these diseases,” the study’s authors said.

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Other CNSIDDs recorded during the study included idiopathic optic neuritis (iON) with an incidence of 0.58 (0.24–0.92) per 100,000 persons per year, acute transverse myelitis (ATM) with an incidence of 0.44 (0.14–0.74) per 100,000 persons per year, idiopathic demyelinating brainstem syndrome (BS) with an incidence of 0.04 (0.01–0.25) per 100,000 persons per year, and acute disseminated encephalomyelitis (ADEM) with an incidence of 0.28 (0.08–1.02) per 100,000 persons per year in the pediatric population.

Disability-adjusted life years for NMOSD patients, which combines years of healthy life lost due to disability and years of life lost from mortality, was a median of 0.57 years (0.00-39.63). The median modified Rankin Scale for NMOSD patients at the last visit was 2.5 (0-6).

Using an ICD-10 search of the Chumphon Khet Udomsak Hospital database between January 1, 2016, and December 31, 2021, an initial 301 CNSIDD cases were identified, of which 74 were ultimately included in the study. This group included 17 NMOSD patients, 3 MS patients, 2 MOGAD patients, 9 ATM patients, 14 iON patients, 1 BS patient, and 2 ADEM patients. 


Tisavipat N, Jitpratoom P, Siritho S, et al. The epidemiology and burden of neuromyelitis optica spectrum disorder, multiple sclerosis, and MOG antibody-associated disease in a province in Thailand: a population-based study. Mult Scler Relat Disord. 2023;70(104511):104511. doi:10.1016/j.msard.2023.104511