Abstract Details

Title Clinical and Radiological Features of Neuromyelitis Optic Spectrum Disorder with and Without Identifiable Triggers

Topic Autoimmune Neurology

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 2-008

Objective To Assess whether presence of identifiable triggers influence the clinical profile and radiological profile of NMOSD patients.

Background Neuromyelitis optic spectrum disorder (NMOSD) is an autoimmune inflammatory demyelinating disorder of the central nervous system (CNS) characterized by optic neuritis (ON) and longitudinally extensive transverse myelitis (LETM). This study aimed to compare the clinical, radiological, and laboratory characteristics of NMOSD patients with identifiable triggers—including recent malignancy, infection or vaccination (within the preceding month), associated autoimmune or rheumatological disorders, and pregnancy or postpartum states—with those without such triggers.

Design/Methods We conducted a single center retrospective cohort analysis of south jersey population from electronic medical records from January 2000 to December 2024, who were tested for aquaporin-4 antibodies. Patients were dichotomised into NMOSD with and without triggers and relevant data was collected. Descriptive and bivariate analysis used for dichotomous variables to summarise results.

Results A total of 43 NMOSD patients were analyzed, comprising 19 with and 24 without identifiable triggers. The median age at onset was lower among those with triggers (28.5 vs. 37.5 years), with comparable female predominance (16/19 vs. 17/24). Clinical features such as acute presentation, optic neuritis, transverse myelitis, and sensory deficits were similar between groups. Area postrema syndrome was significantly more frequent in patients with identifiable triggers (31.6% vs. 4.2%, p=0.033). Trends toward higher CSF protein levels (p=0.054) and predominant central cord involvement on spinal MRI (p=0.067) were observed in the trigger group. No significant differences were noted in antibody positivity, MRI brain abnormalities, use of steroid with plasma exchange at presentation, relapse rates, or discharge diagnosis of NMOSD (p>0.05).

Conclusions Patients with NMOSD associated with identifiable triggers tend to present at a younger age and may exhibit certain distinctive features such as area postrema syndrome and central cord involvement, although overall disease characteristics and outcomes appear largely similar to those without triggers.

Authors/Disclosures
Ashutosh K. Gupta PRESENTER	Mr. Gupta has nothing to disclose.
Humza Qureshi	Mr. Qureshi has nothing to disclose.
Anjali Patel	Miss Patel has nothing to disclose.
Aswathi Sajeendran, MD	Dr. Sajeendran has nothing to disclose.
Olga R. Thon, MD (Cooper Neurological Institute)	Dr. Thon has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Thon has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon. Dr. Thon has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Horizon.
Cris S. Constantinescu, MD, PhD (Cooper Neurological Institute)	Dr. Constantinescu has received publishing royalties from a publication relating to health care.
Donald A. Barone, DO (Cooper Neurologic Institute)	Dr. Barone has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vanda. Dr. Barone has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Serono.
Judy Diep, MD	Dr. Diep has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for TG Therapeutics .

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