Researchers have identified several factors that may increase the risk of permanent disability in patients with neuromyelitis optica spectrum disorder (NMOSD), according to a study published in Multiple Sclerosis and Related Disorders.

After adjustments for confounding factors, multivariate analysis found that age of onset of 50 years or older (P =.021), time from onset to diagnosis of 12 months or more (P =.011), and an Expanded Disability Status Scale (EDSS) of at least 4.0 at the first appointment (P =.033) were all associated with a higher risk of permanent disability.

“This information is required to design healthcare strategies to recognize and treat patients with NMOSD early and aggressively to decrease the rates of [permanent disability] and their effect on both the patients and society,” the authors said.

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Approximately 51% of the patients (34 out of 67) followed in the study developed permanent disability during the follow-up period. Of the patients with disabilities, 15 developed visual disability, 13 had motor disability, and 6 were restricted to wheelchair usage.

Read more about NMOSD prognosis

When comparing patient groups, those who developed disability were generally older and had a longer time period since symptom onset, a longer time between symptom onset and the initiation of treatment, and a higher EDSS score at the first visit.

Univariate analysis found that these were all risk factors for the development of permanent disability with thresholds of 50 or more years of age at onset, at least 12 months from onset to diagnosis, at least 60 months from onset to treatment, and EDSS of 4.0 or higher at first visit.

A total of 67 Mexican patients with NMOSD were included in the study with the majority (74.6%) being female. Optic neuritis was the first symptom in 34 of the patients, myelitis was first in 24, and the remaining 9 had area postrema symptoms. Thirty-eight out of the 48 patients tested were found to be positive for aquaporin-4 immunoglobulin G (AQP4-IgG).


Valdivia-Tangarife ER, Gamez-Nava JI, Cortés-Enríquez F, et al. Risk factors associated with permanent disability in neuromyelitis optica spectrum disorders. Mult Scler Relat Disord. 2022;0(104114):104114. doi:10.1016/j.msard.2022.104114