{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T09:26:41Z","timestamp":1793957201753,"version":"4.8.0"},"reference-count":24,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","msard-journal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Multiple Sclerosis and Related Disorders"],"published-print":{"date-parts":[[2026,11]]},"DOI":"10.1016\/j.msard.2026.107945","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T23:19:42Z","timestamp":1790378382000},"page":"107945","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Diagnostic delay and poor functional outcomes in late-onset NMOSD: A Thai cohort study"],"prefix":"10.1016","volume":"115","author":[{"given":"Krit","family":"Bancherdpongchai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kittipong","family":"Phanmueang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nawee","family":"Suriyun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuttapat","family":"Laohapensang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suwijak","family":"Hongha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanokkarn","family":"Teekaput","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3019-1210","authenticated-orcid":false,"given":"Chutithep","family":"Teekaput","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.msard.2026.107945_bib0001","doi-asserted-by":"crossref","DOI":"10.1016\/j.msard.2026.107391","article-title":"Impact of relapse burden on recovery and disability following acute attacks in Neuromyelitis Optica spectrum disorder: a 10-year Northern Thailand cohort","volume":"113","author":"Chaiwarut","year":"2026","journal-title":"Mult. Scler. Relat. Disord."},{"issue":"6","key":"10.1016\/j.msard.2026.107945_bib0002","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1177\/13524585251325069","article-title":"Smoking status and vascular risk factors as predictors of disability in AQP4-NMOSD and MOGAD","volume":"31","author":"Chan","year":"2025","journal-title":"Mult. Scler."},{"key":"10.1016\/j.msard.2026.107945_bib0003","doi-asserted-by":"crossref","DOI":"10.1016\/j.jneuroim.2023.578223","article-title":"Neuromyelitis optica spectrum disorder mimicking stroke: a case report and literature review","volume":"385","author":"Hu","year":"2023","journal-title":"J. Neuroimmunol."},{"key":"10.1016\/j.msard.2026.107945_bib0004","doi-asserted-by":"crossref","DOI":"10.1016\/j.msard.2025.106302","article-title":"The value of CSF diagnostic and prognostic biomarkers in NMOSD and MOGAD in real-life use","volume":"94","author":"Johnsson","year":"2025","journal-title":"Mult. Scler. Relat. Disord."},{"key":"10.1016\/j.msard.2026.107945_bib0005","doi-asserted-by":"crossref","unstructured":"T. K\u00fcmpfel, K. Giglhuber, O. Aktas, I. Ayzenberg, J. Bellmann-Strobl, V. H\u00e4u\u00dfler, J. Havla, K. Hellwig, M.W. H\u00fcmmert, S. Jarius, I. Kleiter, L. Klotz, M. Krumbholz, F. Paul, M. Ringelstein, K. Ruprecht, M. Senel, J.-P. Stellmann, F.T. Bergh, C. Trebst, H. Tumani, C. Warnke, B. Wildemann, A. Berthele, P. Albrecht, K. Angstwurm, S. Asseyer, A.B.A.G.R. Gomes, A. Bayas, S. Behnke, S. Bittner, F. Buetow, M. Buttmann, A. Duchow, D. Engels, T. Etgen, K. Fischer, B. Frank, A. Gahlen, A. Gass, J. Gehring, C. Geis, R. Gold, Y. G\u00f6reci, J. Graf, S. Groppa, M. Grothe, J. Gutbrod, K. Guthke, A. Haarmann, M. Hastermann, B. Hemmer, M. Herfurth, M. Herwerth, F. Hoffmann, O. Hoffmann, M.W. H\u00fcmmert, L. Husseini, J. Junghans, M. Kaste, P. Kern, K. Kern, P. Kermer, C. Kleinschnitz, W. K\u00f6hler, K. K\u00f6rbel, M. Kowarik, M. Kraemer, J. Kretschmer, N. Kurka, T. Ladopoulus, A.-S. Lauenstein, S. Laurent, D.-H. Lee, D. Lehrieder, F. Leypoldt, M. Liebetrau, R. Linker, G. Lindenblatt, L. Lohmann, F. L\u00fcssi, P. Luedemann, M. Maiworm, M. Marziniak, C. Mayer, S. Meister, M. Mering, I. Metz, S. Meuth, J. Naumann, O. Neuhaus, T. Neziraj, M. Niederschweiberer, S. Niehaus, C. Otto, F. Pache, T. Pakeerathan, S. Passoke, M. Pawlitzki, H. Pellkofer, M. Pompsch, A.-K. Pr\u00f6bstel, R. Pul, S. Rauer, N. Retzlaff, A. Riedlinger, P. Rommer, V. Rothhammer, K. Rost\u00e1sy, R. Rust, C. Ruschil, M. Schwab, M. Seipelt, P. Schindler, C. Schwake, P. Schwarz, C. Sommer, A. Stefanou, T. Sprenger, A. Steinbrecher, H. Stephanik, M. Stoppe, K. St\u00fcrner, M. S\u00fc\u00dfe, A. Tarampanis, S. Tauber, D. Tkachenko, A. Walter, K.-P. Wandinger, A. Walz, M. Weber, J. Weise, J. Wickel, H. Wiendl, A. Winkelmann, Y. Yalachkov, U. Zettl, U. Ziemann, F. Zipp, The Neuromyelitis Optica Study, G., 2024. Update On the Diagnosis and Treatment of Neuromyelitis Optica Spectrum Disorders (NMOSD) \u2013 Revised Recommendations of the Neuromyelitis Optica Study Group (NEMOS). Part II: attack therapy and long-term management. J. Neurol. 271(1), 141\u2013176. http:\/\/doi.org\/10.1007\/s00415-023-11910-z.","DOI":"10.1007\/s00415-024-12288-2"},{"issue":"11","key":"10.1016\/j.msard.2026.107945_bib0006","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1212\/WNL.33.11.1444","article-title":"Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS)","volume":"33","author":"Kurtzke","year":"1983","journal-title":"Neurology"},{"issue":"1","key":"10.1016\/j.msard.2026.107945_bib0007","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1186\/s12883-024-03884-w","article-title":"Neuroimaging feature in identifying acute myelopathy etiologies: comparison between neuromyelitis optica spectrum disorder and cervical spondylotic myelopathy","volume":"24","author":"Luo","year":"2024","journal-title":"BMC. Neurol."},{"key":"10.1016\/j.msard.2026.107945_bib0008","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.msard.2018.12.011","article-title":"Long-term disability in neuromyelitis optica spectrum disorder with a history of myelitis is associated with age at onset, delay in diagnosis\/preventive treatment, MRI lesion length and presence of symptomatic brain lesions","volume":"28","author":"Mealy","year":"2019","journal-title":"Mult. Scler. Relat. Disord."},{"key":"10.1016\/j.msard.2026.107945_bib0009","doi-asserted-by":"crossref","DOI":"10.1016\/j.msard.2023.104517","article-title":"Clinical characteristics of late-onset neuromyelitis optica spectrum disorder","volume":"70","author":"Min","year":"2023","journal-title":"Mult. Scler. Relat. Disord."},{"issue":"8","key":"10.1016\/j.msard.2026.107945_bib0010","doi-asserted-by":"crossref","first-page":"2574","DOI":"10.1111\/ene.14901","article-title":"Very late onset neuromyelitis optica spectrum disorders","volume":"28","author":"Nakahara","year":"2021","journal-title":"Eur. J. Neurol."},{"key":"10.1016\/j.msard.2026.107945_bib0011","series-title":"Clinical Practice Guidelines: Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder","year":"2018"},{"issue":"6","key":"10.1016\/j.msard.2026.107945_bib0012","doi-asserted-by":"crossref","DOI":"10.1111\/ene.70214","article-title":"Comorbidities are associated with unfavorable outcome in aquaporin-4 antibody positive neuromyelitis optica spectrum disorders and myelin oligodendrocyte glycoprotein antibody-associated disease: exploratory study from the CROCTINO cohort","volume":"32","author":"Samadzadeh","year":"2025","journal-title":"Eur. J. Neurol."},{"issue":"6","key":"10.1016\/j.msard.2026.107945_bib0013","doi-asserted-by":"crossref","DOI":"10.1212\/NXI.0000000000000607","article-title":"Late-onset neuromyelitis optica spectrum disorder","volume":"6","author":"Sepulveda","year":"2019","journal-title":"Neurol. Neuroimmunol. Neuroinflammation"},{"key":"10.1016\/j.msard.2026.107945_bib0014","doi-asserted-by":"crossref","DOI":"10.1016\/j.msard.2023.104498","article-title":"Factors associated with the misdiagnosis of neuromyelitis optica spectrum disorder","volume":"70","author":"Smith","year":"2023","journal-title":"Mult. Scler. Relat. Disord."},{"key":"10.1016\/j.msard.2026.107945_bib0015","article-title":"Very late-onset neuromyelitis optica spectrum disorder: differences and difficulties at 96 years-old","volume":"9","author":"Soares","year":"2026","journal-title":"Neuroimmunol. Rep."},{"issue":"1","key":"10.1016\/j.msard.2026.107945_bib0016","doi-asserted-by":"crossref","first-page":"42","DOI":"10.15274\/nrj-2014-10118","article-title":"Neuromyelitis optica: atypical clinical and neuroradiological presentation","volume":"28","author":"Splendiani","year":"2015","journal-title":"Neuroradiol. J."},{"issue":"6","key":"10.1016\/j.msard.2026.107945_bib0017","doi-asserted-by":"crossref","first-page":"415","DOI":"10.2471\/BLT.18.223693","article-title":"Universal health coverage and primary care","volume":"97","author":"Sumriddetchkajorn","year":"2019","journal-title":"Thailand. Bull World Heal. Organ"},{"issue":"7","key":"10.1016\/j.msard.2026.107945_bib0018","doi-asserted-by":"crossref","DOI":"10.3390\/brainsci12070885","article-title":"NMOSD-diagnostic dilemmas leading towards final diagnosis","volume":"12","author":"Szewczyk","year":"2022","journal-title":"Brain Sci."},{"key":"10.1016\/j.msard.2026.107945_bib0019","doi-asserted-by":"crossref","DOI":"10.1016\/j.msard.2025.106266","article-title":"Impact of air pollution on the clinical exacerbation of central demyelinating disease: a 10-year data from the Northern Thailand MS and NMOSD registry","volume":"94","author":"Teekaput","year":"2025","journal-title":"Mult. Scler. Relat. Disord."},{"key":"10.1016\/j.msard.2026.107945_bib0020","doi-asserted-by":"crossref","DOI":"10.1016\/j.msard.2023.104511","article-title":"The epidemiology and burden of neuromyelitis optica spectrum disorder, multiple sclerosis, and MOG antibody-associated disease in a province in Thailand: a population-based study","volume":"70","author":"Tisavipat","year":"2023","journal-title":"Mult. Scler. Relat. Disord."},{"issue":"10","key":"10.1016\/j.msard.2026.107945_bib0021","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1038\/s41582-024-01014-1","article-title":"NMOSD and MOGAD: an evolving disease spectrum","volume":"20","author":"Uzawa","year":"2024","journal-title":"Nat. Rev. Neurol."},{"key":"10.1016\/j.msard.2026.107945_bib0022","doi-asserted-by":"crossref","DOI":"10.1016\/j.msard.2022.104114","article-title":"Risk factors associated with permanent disability in neuromyelitis optica spectrum disorders","volume":"68","author":"Valdivia-Tangarife","year":"2022","journal-title":"Mult. Scler. Relat. Disord."},{"issue":"2","key":"10.1016\/j.msard.2026.107945_bib0023","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1212\/WNL.0000000000001729","article-title":"International consensus diagnostic criteria for neuromyelitis optica spectrum disorders","volume":"85","author":"Wingerchuk","year":"2015","journal-title":"Neurology"},{"key":"10.1016\/j.msard.2026.107945_bib0024","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.msard.2018.12.002","article-title":"Neuromyelitis optica spectrum disorder: pathogenesis, treatment, and experimental models","volume":"27","author":"Wu","year":"2019","journal-title":"Mult. Scler. Relat. Disord."}],"container-title":["Multiple Sclerosis and Related Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2211034826009806?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2211034826009806?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T08:38:42Z","timestamp":1793954322000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2211034826009806"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,11]]},"references-count":24,"alternative-id":["S2211034826009806"],"URL":"https:\/\/doi.org\/10.1016\/j.msard.2026.107945","relation":{},"ISSN":["2211-0348"],"issn-type":[{"value":"2211-0348","type":"print"}],"subject":[],"published":{"date-parts":[[2026,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Diagnostic delay and poor functional outcomes in late-onset NMOSD: A Thai cohort study","name":"articletitle","label":"Article Title"},{"value":"Multiple Sclerosis and Related Disorders","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.msard.2026.107945","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"107945"}}