Researchers from China developed a new classification scheme for cognitive impairments in patients with neuromyelitis optica spectrum disorder (NMOSD), a recent study suggests.

Based on the scheme, the deterioration of motor ability in the arms and legs of the patients can potentially predict cognitive phenotypes in NMOSD.

The findings were recently published in the journal Frontiers in Neurology

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Read more about the symptoms of NMOSD

NMOSD is a rare chronic inflammatory autoimmune disease of the central nervous system characterized by optic neuritis and myelitis that shares many features with multiple sclerosis (MS). Cognitive impairments can potentially develop during the course of both NMOSD and MS.

Researchers still do not agree on whether or not NMOSD leads to cognitive impairments or how often these impairments occur.

For the present study, a team led by Hongyu Zhou, of the Sichuan University in Chengdu, China, sought to classify and characterize the cognitive phenotype of patients with NMOSD.

To do so, they conducted neuropsychological assessments in 66 patients with NMOSD and 22 healthy volunteers. The researchers then compared the results. 

The team identified 4 distinct cognitive phenotypes in patients with NMOSD. These were preserved cognition, mild-attention, mild-multidomain, and severe-multidomain. About 67% of all patients had cognitive impairments. 

The researchers also found that patients with worse cognition were older and had lower education levels, worse Expanded Disability Status Scale scores, and poorer motor function in the legs. 

They also identified deterioration in the Nine-Hole Peg Test and the 12-item Multiple Sclerosis Walking Scale as independent risk factors for severe cognitive dysfunction.

The researchers built a nomogram based on the entire cohort and the above factors as a tool for clinicians to evaluate the risk of severe cognitive dysfunction among their patients.


Kong L, Lang Y, Wang X, et al. Identifying different cognitive phenotypes and their relationship with disability in neuromyelitis optica spectrum disorder. Front. Neurol. 2022;13:958441. doi:10.3389/fneur.2022.958441