Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disorder of the central nervous system predominantly targeting optic nerves and the spinal cord. The prevalence of the disease is much higher in Asia than in other parts of the world. Pain can be detected in more than 80% of NMOSD patients, with evoked pain mostly being caused by painful tonic muscle spasms and neuropathic pain as the most characteristic types. Depression is often comorbid with pain, and their comorbidity can severely influence quality of life. In recent years, studies have found considerable overlaps between the mechanisms of pain and depression; however, their association remains unclear. This article reviews the epidemiology, mechanism, evaluation and treatment of pain-depression comorbidity in NMOSD patients.
Comorbidity ; Depression/epidemiology* ; Humans ; Neuromyelitis Optica/epidemiology* ; Pain ; Quality of Life

Objective To investigate the clinical features of neuromyelitis optica spectrum disorders(NMOSD)with connective tissue diseases(CTD). Methods Clinical data of 16 NMOSD-CTD patients and 54 NMOSD patients admitted to the Second Affiliated Hospital of Fujian Medical University from January 2015 to February 2020 were collected.The initial symptom,intracranial lesion,spinal cord lesion,laboratory examination and treatment response were compared between the two groups. Results The incidence of Sjögren's syndrome(SS)was the highest(10/16,62.5%)in NMOSD-CTD group.The NMOSD-CTD group had significantly higher positive rate of aquaporin-4 immunoglobulin G(AQP4-IgG)in serum or cerebrospinal fluid(100% vs. 70.2%,P=0.009),higher positive rates of serum anti-nuclear antibodies,anti Sjögren's syndrome A antibodies and anti-Ro52 autoantibodies(P<0.001),as well as higher proportion of patients with the expanded disability status scale score ≥ 6(50.0% vs. 22.2%,P=0.035)than the NMOSD group.There was no significant difference between the two groups in the age of onset,visiting age,recurrence frequency,disease course,distribution of intracranial lesions,spinal cord involvement,or the effective rate of glucocorticoid pulse therapy(all P>0.05).Conclusions NMOSD is often complicated with CTD,and SS is the most common one.The positive rate of serum or cerebrospinal AQP4-IgG and the seropositivity of several other autoantibodies in NMOSD-CTD patients were higher than those in NMOSD patients.Neurological impairment in NMOSD-CTD patients were severer,which should arouse attention of clinicians.
Aquaporin 4 ; Autoantibodies ; Connective Tissue Diseases/epidemiology* ; Humans ; Immunoglobulin G ; Neuromyelitis Optica/epidemiology*

Child ; China/epidemiology* ; Cross-Sectional Studies ; Glucocorticoids/therapeutic use* ; Humans ; Neuromyelitis Optica ; Pediatrics

OBJECTIVETo explore the clinical features of neuromyelitis optica (NMO) patients, and to study the distribution of Chinese medical syndrome types and the pathogenesis of NMO.

METHODSThe clinical features, figures of tongue and pulse, Chinese medical syndromes were comprehensively analyzed in 63 NMO patients using statistical methods for clinical data.

RESULTSThe age ratio of male to female in 63 NMO patients was 1: 6.88. Their average age of first onset was 31.67 +/- 12.44 years old, and 28. 57% of patients had obvious inducing factor. Urgent onset with relieved recurrence were often seen, with the average recurrence times of 4.60. Most patients complained about sensation disorders, vision disorders, and movement disorders as their first attack and visit. The Chinese medical syndrome types included Gan-Shen yin deficiency syndrome and phlegm-heat collateral stagnation syndrome, mainly involved Gan and Shen. Gan-Shen yin deficiency, sputum, blood stasis, and heat were most often seen syndrome elements.

CONCLUSIONSGan-Shen yin deficiency was dominated in the deficiency in origin of NMO. Phlegm, blood stasis, mingled heat were main dominant evils. Of them, the pathogenesis of Gan-Shen yin deficiency and phlegm-heat collateral stagnation had universality and representativeness, which could be verified from patients' tongue picture and pulse picture.

Adolescent ; Adult ; Aged ; Child ; Cross-Sectional Studies ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Neuromyelitis Optica ; diagnosis ; epidemiology ; Yang Deficiency ; epidemiology ; Yin Deficiency ; epidemiology ; Young Adult