Age, sex, and the presence of 4 or more thoracic lesions appear to be independent risk factors for neuropathic pain in patients with neuromyelitis optica spectrum disorder (NMOSD), a new study published in BMC Neurology found. However, more research is needed to validate these findings, according to the authors of the study. 

A frequent complication of NMOSD is neuropathic pain. However, it is not known which factors contribute to the development of this complication that adversely affects patients’ quality of life. 

In the present study, a team of researchers from China led by Yuanqi Zhao conducted a retrospective case-cohort study to investigate the risk factors associated with neuropathic pain in 86 patients with NMOSD with aquaporin-4 immunoglobulin G antibodies. Almost half (43%) of the patients had neuropathic pain.

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The researchers found that age at onset of the disease, the type of optic neuritis and myelitis attack, the length of spinal cord involvement, the position of the thoracic, optic, and extended spinal cord lesions, the presence of 4 or more thoracic lesions (ie, extended thoracic lesions), intravenous immunoglobulin, and mycophenolate mofetil were all factors associated with neuropathic pain. 

Read more about the complications of NMOSD

Statistical analyses showed that extended thoracic lesions and age were independently associated with neuropathic pain. Moreover, sex could also be associated with neuropathic pain.

“However, with a small sample size and predominantly female [participants], caution must be applied and these results need validating in further cohorts,” the researchers cautioned.

NMOSD is a rare autoimmune disease involving the central nervous system. It is characterized by the demyelination of the optic nerve and spinal cord causing optic neuritis and myelitis, respectively. 

Other complications of NMOSD include severe visual impairment and blindness, sensory impairment, epileptic seizures, psychiatric problems, confusion, aphasia, apraxia, cognitive decline, respiratory failure, otitis interna, gastritis, and vitamin B12 deficiency.


Li X, Xu H, Zheng Z, et al. The risk factors of neuropathic pain in neuromyelitis optica spectrum disorder: a retrospective case-cohort study. BMC Neurol. 2022;22(1):304. doi:10.1186/s12883-022-02841-9