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In this MD Newsline exclusive interview with neurologist Dr. Mitzi Williams, we discuss risk factors for NMOSD, including patient genetics and sex.

MD Newsline:

Is there a genetic basis for why people of African descent seem to suffer more from NMOSD? 

Dr. Mitzi Williams:

“With demyelinating diseases, including NMOSD, MS, and a condition called ADEM (acute disseminated encephalomyelitis), African Americans often have more optic nerve and spinal cord involvement, even for those who have MS. They also have higher rates of NMOSD. We don’t yet know the reasons behind these findings.

NMOSD is often commonly seen in some Asian populations, such as the Japanese population. And the presentation of NMOSD that we see in African Americans is actually referred to as ‘the Asian variant of MS.’

So, I think there’s a lot of work that we need to do to better understand why we see these differences in disease presentation. One of the biggest issues is we don’t have a lot of diversity in our clinical research. Hopefully, with more diverse recruiting methods, we will begin to understand any underlying genetic or biologic factors that may be leading to these differences in disease presentation and disparate outcomes.”


MD Newsline:

Why do you think more women than men are affected by NMOSD? 

Dr. Mitzi Williams:

“With pretty much all autoimmune diseases, including NMOSD and MS, more women are affected than men. We think estrogen may play a role in these findings. For example, up until puberty and after menopause, the rates of MS are the same for females and males. But during childbearing years, significantly more women than men are affected.

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I think we have a lot of work to do to better understand why more women than men are affected by NMOSD, but my suspicion is there’s a hormonal basis for why more women are affected by the disease.”


Responses have been condensed and lightly edited.

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