AUTHOR=Khalilidehkordi Elham , Clarke Laura , Arnett Simon , Bukhari Wajih , Jimenez Sanchez Sofia , O'Gorman Cullen , Sun Jing , Prain Kerri M. , Woodhall Mark , Silvestrini Roger , Bundell Christine S. , Abernethy David , Bhuta Sandeep , Blum Stefan , Boggild Mike , Boundy Karyn , Brew Bruce J. , Brown Matthew , Brownlee Wallace , Butzkueven Helmut , Carroll William M. , Chen Celia , Coulthard Alan , Dale Russell C. , Das Chandi , Fabis-Pedrini Marzena J. , Fulcher David , Gillis David , Hawke Simon , Heard Robert , Henderson Andrew P. D. , Heshmat Saman , Hodgkinson Suzanne , Kilpatrick Trevor J. , King John , Kneebone Chris , Kornberg Andrew J. , Lechner-Scott Jeannette , Lin Ming-Wei , Lynch Christopher , Macdonell Richard A. L. , Mason Deborah F. , McCombe Pamela A. , Pereira Jennifer , Pollard John D. , Ramanathan Sudarshini , Reddel Stephen W. , Shaw Cameron , Spies Judith , Stankovich James , Sutton Ian , Vucic Steve , Walsh Michael , Wong Richard C. , Yiu Eppie M. , Barnett Michael H. , Kermode Allan G. , Marriott Mark P. , Parratt John , Slee Mark , Taylor Bruce V. , Willoughby Ernest , Brilot Fabienne , Vincent Angela , Waters Patrick , Broadley Simon A. TITLE=Relapse Patterns in NMOSD: Evidence for Earlier Occurrence of Optic Neuritis and Possible Seasonal Variation JOURNAL=Frontiers in Neurology VOLUME=11 YEAR=2020 URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.00537 DOI=10.3389/fneur.2020.00537 ISSN=1664-2295 ABSTRACT=

Neuromyelitis optica spectrum disorders (NMOSD) and multiple sclerosis (MS) show overlap in their clinical features. We performed an analysis of relapses with the aim of determining differences between the two conditions. Cases of NMOSD and age- and sex-matched MS controls were collected from across Australia and New Zealand. Demographic and clinical information, including relapse histories, were recorded using a standard questionnaire. There were 75 cases of NMOSD and 101 MS controls. There were 328 relapses in the NMOSD cases and 375 in MS controls. Spinal cord and optic neuritis attacks were the most common relapses in both NMOSD and MS. Optic neuritis (p < 0.001) and area postrema relapses (P = 0.002) were more common in NMOSD and other brainstem attacks were more common in MS (p < 0.001). Prior to age 30 years, attacks of optic neuritis were more common in NMOSD than transverse myelitis. After 30 this pattern was reversed. Relapses in NMOSD were more likely to be treated with acute immunotherapies and were less likely to recover completely. Analysis by month of relapse in NMOSD showed a trend toward reduced risk of relapse in February to April compared to a peak in November to January (P = 0.065). Optic neuritis and transverse myelitis are the most common types of relapse in NMOSD and MS. Optic neuritis tends to occur more frequently in NMOSD prior to the age of 30, with transverse myelitis being more common thereafter. Relapses in NMOSD were more severe. A seasonal bias for relapses in spring-summer may exist in NMOSD.