Descriptive Analysis of Clinical Presentation in a Caribbean Hispanic Population with Neuromyelitis Optica Spectrum Disorders (NMO-SD)
Marelisa Albelo Martinez1, Jazmin Sotomayor Ortiz2, Jose Avila-Ornelas1, Gishlaine Alfonso1
1Neurology Division, 2School of Medicine, University of Puerto Rico
Objective:
To characterize and compare the initial clinical presentation of NMO-SD between Puerto Rican patients with NMO and MOGAD.
Background:

NMO-SD is a demyelinating disorder of the CNS characterized by optic neuritis, transverse myelitis, and brainstem syndromes. Given the somewhat recent discovery of MOG, not much work is published on how this disorder manifests clinically as part of the NMO spectrum. NMO-SD is more common among non-White populations, specifically of Asian and African descent. Puerto Rico is a population with Afro-Caribbean descent, however to our knowledge there is no published data regarding this spectrum of conditions in our population.

Design/Methods:

Observational retrospective cohort study was conducted via questionnaire with NMO-SD patients. Cohorts were stratified based on seropositive status and evaluated regarding initial clinical presentation and demographic factors. Categorical and numerical data was analyzed using statistical analysis software.

Results:
No statistically significant differences were observed among cohorts; however, the following clinically significant findings were observed: MOG patients (n =9) reported better recovery than AQP4 + patients(n=20). AQP4+ patients displayed a stronger relation to brainstem symptoms than MOG. Additionally, only one MOG patient reported transverse myelitis in contrast to almost half of AQP4 patients reporting this as initial presentation, with a mild correlation (p-value= 0.1, Cramer’s V = 0.1). Expected demographic differences were also confirmed such as greater female to male ratio on both conditions.
Conclusions:

A data repository describing the clinical presentation and sociodemographic characteristics of the Puerto Rican NMO-SD population was successfully compiled. Despite anticipated sample-size driven limitations common to rare diseases, clinical significance was identified in traits of the NMOSD population such as lesion location and clinical manifestation. Additional data should continue being collected to enable stronger relationships to become more apparent.

Acronyms: Neuromyelitis Optica Spectrum Disorder (NMO-SD), Central Nervous System (CNS), Myelin oligodendrocyte glycoprotein (MOG), Aquaporin 4-positive (AQP4+)

10.1212/WNL.0000000000205965