Objective:To investigate the link between the geographical distribution, serum aquaporin 4-immunoglobulin G (AQP4-IgG) status and clinical features of neuromyelitis optica spectrum disorder (NMOSD) patients in Xinjiang.Methods:A total of 107 NMOSD patients diagnosed at the People′s Hospital of Xinjiang Uygur Autonomous Region from April 2015 to March 2024 were recruited. Clinical data such as gender, age, ethnicity, residence at onset, serum AQP4-IgG status, disease duration, and annual relapse rate were collected. The clinical features of Xinjiang′s NMOSD patients were analyzed based on antibody status and geographical distribution.Results:Among the 107 NMOSD patients, 20 are male, 87 are female. They were divided into AQP4-IgG positive (77 cases, 72.0%) and AQP4-IgG negative (30 cases, 28.0%) groups by initial antibody status, and no statistically significant differences were found in gender, first symptoms, ethnicity, Expanded Disability Status Scale (EDSS) scores, annual relapse rate, and disease duration between the 2 groups (all P>0.05). Compared to AQP4-IgG negative patients, AQP4-IgG positive patients had a higher late-onset (age>50 years) proportion [35.1% (27/77) vs 16.7% (5/30), χ2=3.486, P<0.05] and preferred traditional immunosuppressants ( P<0.05). Divided by the Tianshan Mountains, there were 32 southern Xinjiang patients (29.9%,32/107) and 75 northern Xinjiang patients (70.1%,75/107), with statistically significant difference in ethnic distribution ( P<0.001). Although myelitis was the most common initial symptom in both groups, patients in southern Xinjiang had a higher proportion of optic neuritis [31.3% (10/32) vs 17.3% (13/75)], while those in northern Xinjiang showed a higher proportion of brain and brainstem involvement [24.0% (18/75) vs 6.3% (2/32)], with a statistically significant difference ( χ2=5.857, P<0.05). Conclusions:AQP4-IgG-positive NMOSD patients had a higher proportion of late-onset disease and a greater tendency to use conventional immunosuppressants. Although myelitis was the predominant initial symptom in all Xinjiang NMOSD patients, patients in southern Xinjiang presented with optic neuritis more frequently, while those in northern Xinjiang had a higher proportion of symptoms involving the brain and brainstem.

Objective:To investigate the link between the geographical distribution, serum aquaporin 4-immunoglobulin G (AQP4-IgG) status and clinical features of neuromyelitis optica spectrum disorder (NMOSD) patients in Xinjiang.Methods:A total of 107 NMOSD patients diagnosed at the People′s Hospital of Xinjiang Uygur Autonomous Region from April 2015 to March 2024 were recruited. Clinical data such as gender, age, ethnicity, residence at onset, serum AQP4-IgG status, disease duration, and annual relapse rate were collected. The clinical features of Xinjiang′s NMOSD patients were analyzed based on antibody status and geographical distribution.Results:Among the 107 NMOSD patients, 20 are male, 87 are female. They were divided into AQP4-IgG positive (77 cases, 72.0%) and AQP4-IgG negative (30 cases, 28.0%) groups by initial antibody status, and no statistically significant differences were found in gender, first symptoms, ethnicity, Expanded Disability Status Scale (EDSS) scores, annual relapse rate, and disease duration between the 2 groups (all P>0.05). Compared to AQP4-IgG negative patients, AQP4-IgG positive patients had a higher late-onset (age>50 years) proportion [35.1% (27/77) vs 16.7% (5/30), χ2=3.486, P<0.05] and preferred traditional immunosuppressants ( P<0.05). Divided by the Tianshan Mountains, there were 32 southern Xinjiang patients (29.9%,32/107) and 75 northern Xinjiang patients (70.1%,75/107), with statistically significant difference in ethnic distribution ( P<0.001). Although myelitis was the most common initial symptom in both groups, patients in southern Xinjiang had a higher proportion of optic neuritis [31.3% (10/32) vs 17.3% (13/75)], while those in northern Xinjiang showed a higher proportion of brain and brainstem involvement [24.0% (18/75) vs 6.3% (2/32)], with a statistically significant difference ( χ2=5.857, P<0.05). Conclusions:AQP4-IgG-positive NMOSD patients had a higher proportion of late-onset disease and a greater tendency to use conventional immunosuppressants. Although myelitis was the predominant initial symptom in all Xinjiang NMOSD patients, patients in southern Xinjiang presented with optic neuritis more frequently, while those in northern Xinjiang had a higher proportion of symptoms involving the brain and brainstem.