Sung-Min Kim1, Patrick Waters2, Mark Woodhall2, Yoo-Jin Kim3, Jin-Ah Kim1, So Young Cheon1, Sehoon Lee4, Seong Rae Jo4, Dong Gun Kim4, Kyeong Cheon Jung3, Kwang-Woo Lee1, Jung-Joon Sung1, Kyung Seok Park5. 1. Department of Neurology, Seoul National University College of Medicine, Seoul, Korea. 2. Nuffield Department of Clinical Neurosciences, Neuroimmunology Group, Oxford, UK. 3. Department of Pathology, Seoul National University College of Medicine, Seoul, Korea. 4. Department of Neurology, Seoul National University, Bundang Hospital, Seongnam, Korea. 5. Department of Neurology, Seoul National University College of Medicine, Seoul, Korea/Department of Neurology, Seoul National University, Bundang Hospital, Seongnam, Korea.
Abstract
BACKGROUND: Neuromyelitis optica spectrum disorder with aquaporin4-immunoglobulin G (NMOSD-AQP4) is an inflammatory disease characterised by a high female predominance. However, the effect of gender in patients with NMOSD-AQP4 has not been fully evaluated. OBJECTIVE: The aim of this study was to determine the effect of gender in clinical manifestations and prognosis of patients with NMOSD-AQP4. METHODS: The demographics, clinical and radiological characteristics, pattern reversal visual evoked potential (VEP) test results, and prognosis of 102 patients (18 males) with NMOSD-AQP4 were assessed. RESULTS: Male patients had a higher age at onset (48.7 vs 41 years, p = 0.037) and less optic neuritis as the onset attack (17% vs 44%, p = 0.026), higher tendency to manifest as isolated myelitis over the follow-up period (67% vs 28%, p = 0.005), fewer optic neuritis attacks per year (0.08 vs 0.27, p < 0.001), and shorter relative P100 latency on VEP testing (97.1% vs 108.3%, p = 0.001). Moreover, male gender was significantly associated with the absence of optic neuritis attacks over the follow-up period independent of their age of onset. CONCLUSION: In NMOSD-AQP4 patients, gender impacts on disease onset age and site of attack. This may be an important clue in identifying NMOSD-AQP4 patients with limited manifestations as well as in predicting their clinical courses.
BACKGROUND:Neuromyelitis optica spectrum disorder with aquaporin4-immunoglobulin G (NMOSD-AQP4) is an inflammatory disease characterised by a high female predominance. However, the effect of gender in patients with NMOSD-AQP4 has not been fully evaluated. OBJECTIVE: The aim of this study was to determine the effect of gender in clinical manifestations and prognosis of patients with NMOSD-AQP4. METHODS: The demographics, clinical and radiological characteristics, pattern reversal visual evoked potential (VEP) test results, and prognosis of 102 patients (18 males) with NMOSD-AQP4 were assessed. RESULTS: Male patients had a higher age at onset (48.7 vs 41 years, p = 0.037) and less optic neuritis as the onset attack (17% vs 44%, p = 0.026), higher tendency to manifest as isolated myelitis over the follow-up period (67% vs 28%, p = 0.005), fewer optic neuritis attacks per year (0.08 vs 0.27, p < 0.001), and shorter relative P100 latency on VEP testing (97.1% vs 108.3%, p = 0.001). Moreover, male gender was significantly associated with the absence of optic neuritis attacks over the follow-up period independent of their age of onset. CONCLUSION: In NMOSD-AQP4patients, gender impacts on disease onset age and site of attack. This may be an important clue in identifying NMOSD-AQP4patients with limited manifestations as well as in predicting their clinical courses.
Entities:
Keywords:
Neuromyelitis optica; age; anti-aquaporin4 antibody; gender; multiple sclerosis; sex
Authors: Hye Lim Lee; Jae Young Kim; Jin Myoung Seok; Yoon Ho Hong; Nam Gu Lim; Ha Young Shin; Byung Jo Kim; Soon Young Hwang; Ju Hong Min; Byoung Joon Kim Journal: J Korean Med Sci Date: 2020-05-04 Impact factor: 2.153