The clinical profile of NMOSD in Australia and New Zealand

Wajih Bukhari^#¹, Laura Clarke^#^{1

2}, Cullen O'Gorman^{1

2}, Elham Khalilidehkordi^{1

3}, Simon Arnett^{1

3}, Kerri M Prain⁴, Mark Woodhall⁵, Roger Silvestrini⁶, Christine S Bundell⁷, Sudarshini Ramanathan⁸, David Abernethy⁹, Sandeep Bhuta¹, Stefan Blum¹⁰, Mike Boggild¹¹, Karyn Boundy¹², Bruce J Brew¹³, Wallace Brownlee¹⁴, Helmut Butzkueven¹⁵, William M Carroll¹⁶, Celia Chen¹⁷, Alan Coulthard¹⁸, Russell C Dale¹⁹, Chandi Das²⁰, Keith Dear²¹, Marzena J Fabis-Pedrini²², David Fulcher²³, David Gillis¹⁸, Simon Hawke²³, Robert Heard¹⁹, Andrew P D Henderson²⁴, Saman Heshmat¹, Suzanne Hodgkinson²⁵, Sofia Jimenez-Sanchez¹, Trevor J Kilpatrick²⁶, John King²⁷, Chris Kneebone¹¹, Andrew J Kornberg²⁸, Jeannette Lechner-Scott²⁹, Ming-Wei Lin²³, Christopher Lynch³⁰, Richard A L Macdonnell³¹, Deborah F Mason³², Pamela A McCombe³³, Jennifer Pereira³⁰, John D Pollard²³, Stephen W Reddel³⁴, Cameron Shaw³⁵, Judith Spies²³, James Stankovich³⁶, Ian Sutton³⁷, Steve Vucic¹⁹, Michael Walsh⁹, Richard C Wong¹⁸, Eppie M Yiu²⁸, Michael H Barnett³⁴, Allan G Kermode¹⁶, Mark P Marriott¹⁵, John Parratt²³, Mark Slee¹⁷, Bruce V Taylor³⁵, Ernest Willoughby¹⁴, Robert J Wilson², Fabienne Brilot⁷, Angela Vincent⁴, Patrick Waters⁴, Simon A Broadley^{38

39}

Affiliations

¹ Menzies Health Institute Queensland, School of Medicine, Griffith University, Gold Coast Campus, Gold Coast, QLD, 4222, Australia.
² Department of Neurology, Princess Alexandra Hospital, Wooloongabba, QLD, 4102, Australia.
³ Department of Neurology, Gold Coast University Hospital, Southport, QLD, 4215, Australia.
⁴ Department of Immunology, Pathology Queensland, Royal Brisbane and Women's Hospital, Herston, QLD, 4006, Australia.
⁵ Nuffield Department of Clinical Neurosciences, John Radcliffe Infirmary, University of Oxford, Oxford, OX3 9DU, UK.
⁶ Department of Immunopathology, Westmead Hospital, Westmead, NSW, 2145, Australia.
⁷ School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, WA, 6009, Australia.
⁸ Brain Autoimmunity Group, Institute for Neuroscience and Muscle Research, The Kids Research Institute at the Children's Hospital, Westmead, NSW, 2145, Australia.
⁹ Department of Neurology, Wellington Hospital, Newtown, 6021, New Zealand.
¹⁰ Department of Neurology, Princess Alexandra Hospital, Woolloongabba, QLD, 4102, Australia.
¹¹ Department of Neurology, Townsville Hospital, Douglas, QLD, 4814, Australia.
¹² Department of Neurology, Royal Adelaide Hospital, Adelaide, SA, 5000, Australia.
¹³ Centre for Applied Medical Research, St Vincent's Hospital, University of New South Wales, Darlinghurst, NSW, 2010, Australia.
¹⁴ Department of Neurology, Auckland City Hospital, Grafton, 1023, New Zealand.
¹⁵ Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, 3010, Australia.
¹⁶ Centre for Neuromuscular and Neurological Disorders, Queen Elizabeth II Medical Centre, University of Western Australia, Nedlands, WA, 6009, Australia.
¹⁷ Flinders Medical Centre, Flinders University, Bedford Park, SA, 5042, Australia.
¹⁸ School of Medicine, Royal Brisbane and Women's Hospital, University of Queensland, Herston, QLD, 4029, Australia.
¹⁹ The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, Westmead, NSW, 2145, Australia.
²⁰ Department of Neurology, Canberra Hospital, Garran, ACT, 2605, Australia.
²¹ Global Health Research Centre, Duke Kunshan University, Kunshan, Jiangsu, China.
²² Western Australian Neuroscience Research Institute, Queen Elizabeth II Medical Centre, University of Western Australia, Nedlands, WA, 6009, Australia.
²³ Sydney Medical School, Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW, 2006, Australia.
²⁴ Department of Neurology, Westmead Hospital, Westmead, NSW, 2145, Australia.
²⁵ South Western Sydney Medical School, Liverpool Hospital, University of New South Wales, Liverpool, NSW, 2170, Australia.
²⁶ Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, 3010, Australia.
²⁷ Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, 3010, Australia.
²⁸ School of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, 3010, Australia.
²⁹ Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, 2305, Australia.
³⁰ School of Medicine, University of Auckland, Grafton, 1142, New Zealand.
³¹ Department of Neurology, Austin Health, Heidelberg, VIC, 3084, Australia.
³² Department of Neurology, Christchurch Hospital, Christchurch, 8140, New Zealand.
³³ Centre for Clinical Research, Royal Brisbane and Women's Hospital, University of Queensland, Herston, QLD, 4029, Australia.
³⁴ Brain and Mind Research Institute, University of Sydney, Camperdown, NSW, 2006, Australia.
³⁵ School of Medicine, Deakin University, Waurn Ponds, VIC, 3217, Australia.
³⁶ Menzies Research Institute, University of Tasmania, Hobart, TAS, 7000, Australia.
³⁷ Department of Neurology, St Vincent's Hospital, Darlinghurst, NSW, 2010, Australia.
³⁸ Menzies Health Institute Queensland, School of Medicine, Griffith University, Gold Coast Campus, Gold Coast, QLD, 4222, Australia. simon.broadley@griffith.edu.au.
³⁹ Department of Neurology, Gold Coast University Hospital, Southport, QLD, 4215, Australia. simon.broadley@griffith.edu.au.

^# Contributed equally.

PMID: 32006158
DOI: 10.1007/s00415-020-09716-4

The clinical profile of NMOSD in Australia and New Zealand

Wajih Bukhari et al. J Neurol. 2020 May.

. 2020 May;267(5):1431-1443.

doi: 10.1007/s00415-020-09716-4. Epub 2020 Jan 31.

Authors

Affiliations

¹ Menzies Health Institute Queensland, School of Medicine, Griffith University, Gold Coast Campus, Gold Coast, QLD, 4222, Australia.
² Department of Neurology, Princess Alexandra Hospital, Wooloongabba, QLD, 4102, Australia.
³ Department of Neurology, Gold Coast University Hospital, Southport, QLD, 4215, Australia.
⁴ Department of Immunology, Pathology Queensland, Royal Brisbane and Women's Hospital, Herston, QLD, 4006, Australia.
⁵ Nuffield Department of Clinical Neurosciences, John Radcliffe Infirmary, University of Oxford, Oxford, OX3 9DU, UK.
⁶ Department of Immunopathology, Westmead Hospital, Westmead, NSW, 2145, Australia.
⁷ School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, WA, 6009, Australia.
⁸ Brain Autoimmunity Group, Institute for Neuroscience and Muscle Research, The Kids Research Institute at the Children's Hospital, Westmead, NSW, 2145, Australia.
⁹ Department of Neurology, Wellington Hospital, Newtown, 6021, New Zealand.
¹⁰ Department of Neurology, Princess Alexandra Hospital, Woolloongabba, QLD, 4102, Australia.
¹¹ Department of Neurology, Townsville Hospital, Douglas, QLD, 4814, Australia.
¹² Department of Neurology, Royal Adelaide Hospital, Adelaide, SA, 5000, Australia.
¹³ Centre for Applied Medical Research, St Vincent's Hospital, University of New South Wales, Darlinghurst, NSW, 2010, Australia.
¹⁴ Department of Neurology, Auckland City Hospital, Grafton, 1023, New Zealand.
¹⁵ Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, 3010, Australia.
¹⁶ Centre for Neuromuscular and Neurological Disorders, Queen Elizabeth II Medical Centre, University of Western Australia, Nedlands, WA, 6009, Australia.
¹⁷ Flinders Medical Centre, Flinders University, Bedford Park, SA, 5042, Australia.
¹⁸ School of Medicine, Royal Brisbane and Women's Hospital, University of Queensland, Herston, QLD, 4029, Australia.
¹⁹ The Children's Hospital at Westmead, Faculty of Medicine and Health, University of Sydney, Westmead, NSW, 2145, Australia.
²⁰ Department of Neurology, Canberra Hospital, Garran, ACT, 2605, Australia.
²¹ Global Health Research Centre, Duke Kunshan University, Kunshan, Jiangsu, China.
²² Western Australian Neuroscience Research Institute, Queen Elizabeth II Medical Centre, University of Western Australia, Nedlands, WA, 6009, Australia.
²³ Sydney Medical School, Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW, 2006, Australia.
²⁴ Department of Neurology, Westmead Hospital, Westmead, NSW, 2145, Australia.
²⁵ South Western Sydney Medical School, Liverpool Hospital, University of New South Wales, Liverpool, NSW, 2170, Australia.
²⁶ Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, 3010, Australia.
²⁷ Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, 3010, Australia.
²⁸ School of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, 3010, Australia.
²⁹ Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, 2305, Australia.
³⁰ School of Medicine, University of Auckland, Grafton, 1142, New Zealand.
³¹ Department of Neurology, Austin Health, Heidelberg, VIC, 3084, Australia.
³² Department of Neurology, Christchurch Hospital, Christchurch, 8140, New Zealand.
³³ Centre for Clinical Research, Royal Brisbane and Women's Hospital, University of Queensland, Herston, QLD, 4029, Australia.
³⁴ Brain and Mind Research Institute, University of Sydney, Camperdown, NSW, 2006, Australia.
³⁵ School of Medicine, Deakin University, Waurn Ponds, VIC, 3217, Australia.
³⁶ Menzies Research Institute, University of Tasmania, Hobart, TAS, 7000, Australia.
³⁷ Department of Neurology, St Vincent's Hospital, Darlinghurst, NSW, 2010, Australia.
³⁸ Menzies Health Institute Queensland, School of Medicine, Griffith University, Gold Coast Campus, Gold Coast, QLD, 4222, Australia. simon.broadley@griffith.edu.au.
³⁹ Department of Neurology, Gold Coast University Hospital, Southport, QLD, 4215, Australia. simon.broadley@griffith.edu.au.

^# Contributed equally.

PMID: 32006158
DOI: 10.1007/s00415-020-09716-4

Abstract

Neuromyelitis optica spectrum disorders (NMOSD) are an inflammation of the central nervous system associated with autoantibodies to aquaporin-4. We have undertaken a clinic-based survey of NMOSD in the Australia and New Zealand populations with the aim of characterising the clinical features and establishing the value of recently revised diagnostic criteria. Cases of possible NMOSD and age and sex-matched controls with multiple sclerosis (MS) were referred from centres across Australia and New Zealand. Cases were classified as NMOSD if they met the 2015 IPND criteria and remained as suspected NMOSD if they did not. Clinical and paraclinical data were compared across the three groups. NMOSD was confirmed in 75 cases and 89 had suspected NMOSD. There were 101 controls with MS. Age at onset, relapse rates and EDSS scores were significantly higher in NMOSD than in MS. Lesions and symptoms referable to the optic nerve were more common in NMOSD whereas brainstem, cerebellar and cerebral lesions were more common in MS. Longitudinally extensive spinal cord lesions were seen in 48/71 (68%) of cases with NMOSD. Elevations of CSF, white cell count and protein were more common in NMOSD. We have confirmed a clinical pattern of NMOSD that has been seen in several geographical regions. We have demonstrated the clinical utility of the current diagnostic criteria. Distinct patterns of disease are evident in NMOSD and MS, but there remains a large number of patients with NMOSD-like features who do not meet the current diagnostic criteria for NMOSD and remain a diagnostic challenge.

Keywords: Aquaporin; Autoimmune disease; Clinical features; Multiple sclerosis; Neuromyelitis optica.

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References

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The clinical profile of NMOSD in Australia and New Zealand

Affiliations

The clinical profile of NMOSD in Australia and New Zealand

Authors

Affiliations

Abstract

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous