Understanding NMOSD in Relation to Multiple Sclerosis: Michael Levy, MD, PhD

WATCH TIME: 3 minutes

“We used to think [NMOSD] was a variant of multiple sclerosis, as the phenotype looks the same with optic neuritis and transverse myelitis. Patients with multiple sclerosis get those two but for a long time, NMO was just thought to be a more severe type of multiple sclerosis. We know that the immunology is completely different between these diseases.”

The pathogenesis that contributes to the diagnosis of neuromyelitis optica spectrum disorder (NMOSD) is a major autoimmune antibody called anti-aquaporin-4 (AQP-4) immunoglobulin G (IgG).¹ A key factor that influences the prognosis of NMOSD is the age onset of the disease. According to recent research, approximately 40% of patients with NMOSD are misdiagnosed with multiple sclerosis (MS) or other similar-looking diseases.² NMOSD is often presented as a disability with severe sensory impairment, combined with sleep disorders, which may directly impact a patient’s quality of life.

Michael Levy, MD, PhD, associate professor at Harvard Medical School, sat down with NeurologyLive^® in an interview to talk about the difference between 2 similar diseases, MS and NMOSD. Levy, who is also a neuroimmunologist at Massachusetts General Hospital, regularly sees patients with autoimmune diseases of the central nervous system, including NMOSD and MOG, transverse myelitis, and some cases of MS. He talked about how the differences in how clinicians perceived disease biology and their comprehension of the disease currently. Additionally, Levy discussed the biomarker that is tested for the diagnosis of NMOSD in comparison with multiple sclerosis.

REFERENCES
1. Min W, Zhang L, Wang S, Xue M, Guo C, Zhu M. Clinical characteristics of late-onset neuromyelitis optica spectrum disorder. Mult Scler Relat Disord. 2023;70:104517. doi:10.1016/j.msard.2023.104517
2. Smith AD, Moog TM, Burgess KW, McCreary M, Okuda DT. Factors associated with the misdiagnosis of neuromyelitis optica spectrum disorder. Mult Scler Relat Disord. 2023;70:104498. doi:10.1016/j.msard.2023.104498