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Depression and initial spinal cord involvement are among the factors associated with neuropathic pain in patients diagnosed with neuromyelitis optical spectrum disorders.

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune inflammatory disorder with severe demyelination, especially of the optic nerve, brain, and spinal cord. Neuropathic pain is a common yet underrecognized symptom of NMOSD. The factors associated with neuropathic pain in NMOSD patients include depression and initial spinal cord involvement. These findings are published in the Multiple Sclerosis and Related Disorders.

Neuropathic Pain in NMOSD Reduces Quality of Life

The study findings included sensory and pyramidal scores on the Expanded Disability Status Scale (EDSS) that were comparatively greater in patients who reported neuropathic pain compared to patients without neuropathic pain. This indicates that neuropathic pain affects sensory and pyramidal functions in NMOSD patients.

Neuropathic Pain Affects Daily Life Activities 

As illustrated by the Brief Pain Inventory (BPI) scale, neuropathic pain had a greater influence on the daily life activities of NMOSD patients than other types of pain. The differences were evident in the significantly lower scores of physical and mental component summaries in patients suffering from neuropathic pain compared to those who did not report neuropathic pain.

Depression Is Correlated With Neuropathic Pain

It has previously been reported that 28% of the patients diagnosed with NMOSD exhibit symptoms of moderate to severe depression. This proportion is significantly higher than the global estimated depression rate of 5.5–5.9% of the general population. NMOSD patients with depressive symptoms are not appropriately managed due to insufficient management of these symptoms. Of the study participants, 44.9% fulfilled the diagnostic criteria for moderate to severe depression; however, none of the patients had received antidepressant pharmacotherapies, indicating the underestimation of depression in the study cohort.

Spinal Involvement Is Associated With Neuropathic Pain 

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NMOSD patients with spinal involvement may develop both nociceptive and neuropathic pain. This study suggests evaluating, monitoring, and treating neuropathic pain in patients with spinal cord involvement.

Depression and initial involvement of the spinal cord in NMOSD patients indicate neuropathic pain to be a common symptom of this inflammatory disorder.


Zhang, X., Pei, L., Xu, Y., Zhang, Y., Lu, Z., Song, S., Tian, Y., Zhao, X., Yin, H., Wang, W., & Huang, Y. (2022). Factors correlated with neuropathic pain in patients with neuromyelitis optica spectrum disorder. Mult Scler Relat Disord, 68, 104213. https://doi.org/10.1016/j.msard.2022.104213