Prolactin could play a role in the pathogenesis of neuromyelitis optica spectrum disorder (NMOSD), according to a recent study in Neurological Sciences.

This cross-sectional study, part of the Registered Cohort Study of Inflammatory Demyelination Disease, has focused on the association between plasma prolactin levels and clinical presentations in NMOSD and other inflammatory demyelinating diseases.

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The cohort consisted of 66 patients with NMOSD (59 females and 7 males), 15 myelin patients with oligodendrocyte glycoprotein antibody disease (3 females and 12 males), and 14 patients with multiple sclerosis (10 females and 4 males). Additionally, 43 healthy volunteers represented the control group for comparison.

“Therefore, it is reasonable to investigate whether bromocriptine can be used in NMOSD treatment,” the authors wrote.

Among the noteworthy findings, the study observed significantly higher plasma prolactin levels in patients with NMOSD compared to the healthy control group. This elevation was particularly prominent during the acute phase of the disease.

The research also highlighted that the role of prolactin in NMOSD might be proinflammatory due to its stimulatory effects on B lymphocyte activation and antibody production. Notably, the researchers noted an association between increased prolactin levels and diencephalic syndrome, a condition affecting the thalamus, hypothalamus, and periventricular area.

Given these results, the authors infer that addressing high prolactin levels could potentially reduce the risk of recurrence in patients with NMOSD. Previous experiences treating conditions like systemic lupus erythematosus with bromocriptine have shown promise, prompting researchers to explore its potential application in NMOSD treatment, the authors noted.

Despite the significant insights provided by this study, certain limitations exist. Sample sizes for the demyelinating disease group and healthy controls were relatively small, warranting further investigation to enhance the reliability of the findings. Additionally, more extensive studies are necessary to establish causal relationships and potential synergies between prolactin, hormonal milieu, immune systems, and cytokines.

“Whether there is a consistent association between clinical symptoms, MRI findings, and PRL levels in diencephalic syndrome or cerebrum syndrome needs to be clarified by expanding the number of observational samples,” the investigators concluded.


Liu H, Zhang X, Chen W, et al. The relationship between plasma prolactin levels and clinical manifestations with neuromyelitis optica spectrum disorders. Neurol Sci. Published online August 25, 2023. doi:10.1007/s10072-023-07008-z