title: Gender effect on neuromyelitis optica spectrum disorder with aquaporin4-immunoglobulin G.
abstract: BACKGROUND
  Neuromyelitis optica spectrum disorder with aquaporin4-immunoglobulin G (NMOSD-AQP4) is an inflammatory disease characterised by a high female predominance. However, the effect of gender in patients with NMOSD-AQP4 has not been fully evaluated.
  
  
  OBJECTIVE
  The aim of this study was to determine the effect of gender in clinical manifestations and prognosis of patients with NMOSD-AQP4.
  
  
  METHODS
  The demographics, clinical and radiological characteristics, pattern reversal visual evoked potential (VEP) test results, and prognosis of 102 patients (18 males) with NMOSD-AQP4 were assessed.
  
  
  RESULTS
  Male patients had a higher age at onset (48.7 vs 41 years, p = 0.037) and less optic neuritis as the onset attack (17% vs 44%, p = 0.026), higher tendency to manifest as isolated myelitis over the follow-up period (67% vs 28%, p = 0.005), fewer optic neuritis attacks per year (0.08 vs 0.27, p < 0.001), and shorter relative P100 latency on VEP testing (97.1% vs 108.3%, p = 0.001). Moreover, male gender was significantly associated with the absence of optic neuritis attacks over the follow-up period independent of their age of onset.
  
  
  CONCLUSIONS
  In NMOSD-AQP4 patients, gender impacts on disease onset age and site of attack. This may be an important clue in identifying NMOSD-AQP4 patients with limited manifestations as well as in predicting their clinical courses.
authors.affiliation: Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Sung-Min
authors.initials: SM
authors.lastname: Kim
authors.affiliation: Nuffield Department of Clinical Neurosciences, Neuroimmunology Group, Oxford, UK.
authors.forename: Patrick
authors.initials: P
authors.lastname: Waters
authors.affiliation: Nuffield Department of Clinical Neurosciences, Neuroimmunology Group, Oxford, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Woodhall
authors.affiliation: Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Yoo-Jin
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jin-Ah
authors.initials: JA
authors.lastname: Kim
authors.affiliation: Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: So Young
authors.initials: SY
authors.lastname: Cheon
authors.affiliation: Department of Neurology, Seoul National University, Bundang Hospital, Seongnam, Korea.
authors.forename: Sehoon
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Neurology, Seoul National University, Bundang Hospital, Seongnam, Korea.
authors.forename: Seong Rae
authors.initials: SR
authors.lastname: Jo
authors.affiliation: Department of Neurology, Seoul National University, Bundang Hospital, Seongnam, Korea.
authors.forename: Dong Gun
authors.initials: DG
authors.lastname: Kim
authors.affiliation: Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Kyeong Cheon
authors.initials: KC
authors.lastname: Jung
authors.affiliation: Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Kwang-Woo
authors.initials: KW
authors.lastname: Lee
authors.affiliation: Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jung-Joon
authors.initials: JJ
authors.lastname: Sung
authors.affiliation: Department of Neurology, Seoul National University College of Medicine, Seoul, Korea/Department of Neurology, Seoul National University, Bundang Hospital, Seongnam, Korea.
authors.forename: Kyung Seok
authors.initials: KS
authors.lastname: Park
mesh_terms: D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D051401:Aquaporin 4 / Q000276:immunology*; D001323:Autoantibodies / Q000276:immunology; D005074:Evoked Potentials, Visual; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000276:immunology*; D012727:Sex Characteristics; D055815:Young Adult
chemical_list: C496030:AQP4 protein, human; D051401:Aquaporin 4; D001323:Autoantibodies; D007074:Immunoglobulin G
keywords: Neuromyelitis optica; age; anti-aquaporin4 antibody; gender; multiple sclerosis; sex