Insufficient treatment of severe depression in neuromyelitis optica spectrum disorder

Chavarro, Velina S.; Mealy, Maureen A.; Simpson, Alexandra; Lacheta, Anna; Pache, Florence; Ruprecht, Klemens; Gold, Stefan M.; Paul, Friedemann; Brandt, Alexander U.; Lévy, Michaël

doi:10.1212/nxi.0000000000000286

Cited by 90 publications

(77 citation statements)

References 42 publications

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“…In NMOSD and MS, fatigue has been reported to impair activities of the daily living [6,[8][9][10]. In MS patients, the prevalence of fatigue was reported to be 50% to 90%, and more than 20 trials were performed to determine the appropriate treatment for fatigue [6,11]. Another study showed 36.5% of early MS patients exhibited fatigue [12].…”

Section: Introductionmentioning

confidence: 99%

Difference in fatigue and pain between neuromyelitis optica spectrum disorder and multiple sclerosis

et al. 2020

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ObjectiveTo investigate the difference of fatigue and pain in patients with neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS). MethodsData from the Modified Fatigue Impact Scale (MFIS) and Pain Effects Scale (PES) were compared between 51 NMOSD and 85 MS patients. Each score was compared in each disease group with or without clinical abnormalities. Since almost no MS patients are without brain magnetic resonance imaging abnormalities, volumetry analysis by the Lesion Segmentation Tool and statistical parametric mapping 12 were added to obtain total lesion volume and intracranial volume in MS patients, and the correlations between total lesion volume/intracranial volume and each score were investigated. ResultsCompared to the MS group, the NMOSD group showed a higher PES score (median, 15.0 vs. 7.0, P = 0.045), no difference in MFIS, and an increased percentage of patients with extended spinal cord lesions (58.8% vs. 8.2%, P < 0.001). Moreover, NMOSD and MS patients with extended spinal cord lesions tended to demonstrate higher PES scores than those without. A positive correlation between MFIS and PES were found in patients with NMOSD and MS. On the other hand, MS patients showed a higher percentage of brain abnormalities (80.4% vs. 97.6%, P = 0.001) and a positive correlation between total lesion volume/intracranial volume and MFIS (Spearman's ρ = 0.50, P = 0.033). ConclusionsThe origin of fatigue may be associated with spinal cord lesions causing pain in NMOSD patients, but with brain lesions in MS patients.

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Section: Introductionmentioning

confidence: 99%

Difference in fatigue and pain between neuromyelitis optica spectrum disorder and multiple sclerosis

et al. 2020

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“…Furthermore, certain lesions that were considered to be neurologically asymptomatic may in fact cause subtle neurologic manifestations that could be masked by more prominent symptoms in the context of an attack of ON or myelitis. A recent study reported that 28% of patients with NMOSD suffered from unrecognized and untreated depression which was also associated with neuropathic pain and fatigue [13]. The unrecognized depression and fatigue in NMOSD patients could also make us overlook subtle symptoms from brain lesions at least in some of our patients.…”

Section: Discussionmentioning

confidence: 93%

Occurrence of Asymptomatic Acute Neuromyelitis Optica Spectrum Disorder-Typical Brain Lesions during an Attack of Optic Neuritis or Myelitis

et al. 2016

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We aimed to investigate the frequency of asymptomatic acute brain MRI abnormalities accompanying optic neuritis (ON) or myelitis in neuromyelitis optica spectrum disorder (NMOSD) patients with aquaporin-4 antibodies (AQP4-Ab). We reviewed 324 brain MRI scans that were obtained during acute attacks of ON or myelitis, in 165 NMOSD patients with AQP4-Ab. We observed that acute asymptomatic NMOSD-typical brain lesions accompanied 27 (8%) acute attacks of ON or myelitis in 24 (15%) patients. The most common asymptomatic brain abnormalities included edematous corpus callosum lesions (n = 17), followed by lesions on the internal capsule and/or cerebral peduncle lesions (n = 9), periependymal surfaces of the fourth ventricle (n = 5), large deep white matter lesions (n = 4), periependymal cerebral lesions surrounding the lateral ventricles (n = 3), and hypothalamic lesions (n = 1). If asymptomatic NMOSD-typical brain abnormalities were considered as evidence for DIS, while also assuming that the AQP4-IgG status was unknown, the median time to diagnosis using the 2015 diagnosis criteria for NMOSD was shortened from 28 months to 6 months (p = 0.008). Asymptomatic acute NMOSD-typical brain lesions can be accompanied by an acute attack of ON or myelitis. Identifying these asymptomatic brain lesions may help facilitate earlier diagnosis of NMOSD.

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“…1 A study in 2016 has demonstrated that depression in NMOSD patients is linked to neuropathic pain and fatigue if these conditions are poorly treated. 10 Better knowledge regarding the mechanisms of pain in NMOSD patients is urgently needed in order to expand existing knowledge, which in the long run could be beneficial for this group of patients. 7…”

Section: Neuromyelitis Optica Spectrum Disordermentioning

confidence: 99%

Prevalence and Pattern of Craniofacial Pain and Headache in Danish Patients with Neuromyelitis Optica Spectrum Disorder

Nielsen

Illés

et al. 2018

European Neurological Review

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There is a dearth of knowledge about the pattern of pain and somatosensory alterations that co-exist with neuromyelitis optica spectrum disorder (NMOSD). Understanding the presence and underlying mechanisms will assist in better pain management in these patients. This study sought to identify prevalence and pattern of headache, craniofacial pain and abnormalities in somatosensory function within a group of NMOSD patients in Denmark. Six patients (two males, four females; mean age 41.2 ± 8.6 years) participated in a telephone interview. Eight questionnaires were used to assess pain, illness perception, fatigue, anxiety and depression. Pain occurred in several regions, including the head, face, neck, back and legs. Two patients experienced frequent headaches and one had headaches following neck pain. Pain occurred frequently over a 3-month period, ranging from mild to severe and described as ‘burning’ (66.7%), ‘exhausting’ (83.3%) and ‘sharp’ (50%). Correlations were found between pain severity and patients’ ‘ability to walk’ (r=0.889), ‘general activity’ (r=0.901), ‘mood’ (r=0.603), ‘normal work’ (r=0.664), ‘relations with other people’ (r=0.774) and ‘sleep’ (r=0.586). Somatosensory abnormality was only reported in legs. While fatigue had a great impact on patients’ daily life, patients did not report that for anxiety and depression. This study demonstrated that headaches and craniofacial pain occur frequently in NMOSD. Patients’ function, mobility, mood and sleep were all affected by pain. These findings highlight the value of further investigation on headaches, craniofacial and overall pain in NMOSD.

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Insufficient treatment of severe depression in neuromyelitis optica spectrum disorder

Cited by 90 publications

References 42 publications

Difference in fatigue and pain between neuromyelitis optica spectrum disorder and multiple sclerosis

Difference in fatigue and pain between neuromyelitis optica spectrum disorder and multiple sclerosis

Occurrence of Asymptomatic Acute Neuromyelitis Optica Spectrum Disorder-Typical Brain Lesions during an Attack of Optic Neuritis or Myelitis

Prevalence and Pattern of Craniofacial Pain and Headache in Danish Patients with Neuromyelitis Optica Spectrum Disorder

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