Smoking is associated with worse lesion resolution in patients with antiaquaporin-4-positive neuromyelitis optica spectrum disorder (AQP4+NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), according to a new study published in the Multiple Sclerosis Journal. Moreover, the study showed that lesion resolution correlates with clinical recovery. 

“Our findings suggest a detrimental effect of smoking in inflammatory central nervous system (CNS) diseases,” the researchers concluded.

Read more about NMOSD diagnosis

Continue Reading

This is the first study that investigated the effect of smoking on lesion resolution in AQP4+NMOSD and MOGAD. 

The authors conducted a cohort study in 57 patients with AQP4+NMOSD and 48 patients with MOGAD. 

The results showed that current and past smoking was associated with a higher risk of persistent lesions on magnetic resonance imaging scans in patients with both diseases. 

Moreover, lesion resolution was associated with better clinical recovery.

“The role of smoking in exacerbating inflammatory disease, as well as vascular disease, may strengthen educational programmes,” the researchers said. “Additionally, [the] smoking status may be taken into consideration in the clinical management of these conditions, and understanding the underlying pathogenic processes may help develop novel treatments.”

NMOSD is a rare autoimmune disease of the central nervous system characterized by repeated episodes of optic neuritis and severe myelitis. Most patients with the disease have autoantibodies against the AQP4 water channel found on astrocytes. Some patients also have autoantibodies against the myelin oligodendrocyte glycoprotein.

The clinical manifestations of the disease may be different depending on the site of the lesions in the central nervous system and the type of antibody that a patient may have.


Berhanu D, Leal Rato M, Messina S, Leite MI, Geraldes R, Palace J. The effect of smoking on MRI lesion resolution in NMOSD-AQP4 and MOGAD. Mult Scler. Published online August 1, 2023. doi:10.1177/13524585231188485