Objective:

To evaluate whether an individual’s primary spoken language (English vs non-English) is associated with clinical outcomes in Neuromyelitis Optica Spectrum Disorder (NMOSD) in a single U.S academic center. 

Background:

Disparities in disease course and clinical care have been observed in several neurologic disorders, including NMOSD. This study evaluates whether self-reported primary language contributes to disparities in clinical outcomes. 

Design/Methods:

Sixty-seven individuals with a confirmed diagnosis of NMOSD were identified within a single academic center between 2012-August 2025. Demographics (race, sex, age, primary spoken language), clinical history, clinical outcomes (reported relapses, Expanded Disability Scale Score [EDSS], Charleston Comorbidity Index [CCI]) were collected by systematic retrospective chart review. Statistical analyses were conducted using t-tests and linear regression.

Results:

Of 67 patients, 53 were primary English speakers and 14 were primary non-English speakers (5 Spanish, 3 Vietnamese, and 1 each Mandarin, Korean, Balochi, French, Cantonese, Somali). Overall, 52 (77.6%) were female and mean age at diagnosis was 48 years. Self-identified race included 33 White (49%), 13 Asian (19%), 8 Black/African American (12%), 2 American Indian/Alaska Native (3%), 3 Native Hawaiian/Pacific Islander (4.5%), 8 unknown. Primary non-English speakers had fewer reported relapses compared to primary-English speakers (1.6 vs 2.5 relapses, p=0.049). No significant findings were observed in CCI or EDSS between the groups (Mean CCI=2.32 (SD:1.67) primary English; 3.07 (SD: 3.1) primary non-English, p=0.40; Median EDSS=4.0 (SD:2.35) primary English; 3.0 (SD: 2.14) primary non-English, p=0.55). However, cardiovascular comorbidities particularity diabetes, were frequent among primary non-English speakers: five (62.5%) had diabetes mellitus in comparison to seven (15.2%) primary English speakers (p=0.035). Additional analyses related to healthcare utilization and practice patterns will be presented. 

Conclusions:

Primary spoken language may have an impact on the reported number of relapses and cardiovascular risks like diabetes in NMOSD. Future research is needed to explore language-related disparities in a larger-scale multicenter cohort.