{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T15:16:32Z","timestamp":1790435792357,"version":"4.1.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2016,10,6]],"date-time":"2016-10-06T00:00:00Z","timestamp":1475712000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Gender and age at onset are important epidemiological factors influencing prevalence, clinical presentation, and treatment response in autoimmune diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the impact of female sex and fertile age on aquaporin-4-antibody (AQP4-ab) status, attack localization, and response to attack treatment in patients with neuromyelitis optica (NMO) and its spectrum disorders (neuromyelitis optica spectrum disorder (NMOSD)).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Female-to-male ratios, diagnosis at last visit (NMO vs NMOSD), attack localization, attack treatment, and outcome were compared according to sex and age at disease or attack onset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 186 NMO\/SD patients (82% female) were included. In AQP4-ab-positive patients, female predominance was most pronounced during fertile age (female-to-male ratio 23:1). Female patients were more likely to be positive for AQP4-abs (92% vs 55%; p\u2009&lt;\u20090.001). Interval between onset and diagnosis of NMO\/SD was longer in women than in men (mean 54 vs 27\u2009months; p\u2009=\u20090.023). In women, attacks occurring \u2a7d40\u2009years of age were more likely to show complete remission ( p\u2009=\u20090.003) and better response to high-dose intravenous steroids ( p\u2009=\u20090.005) compared to woman at &gt;40\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our data suggest an influence of sex and age on susceptibility to AQP4-ab-positive NMO\/SD. Genetic and hormonal factors might contribute to pathophysiology of NMO\/SD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1352458516671203","type":"journal-article","created":{"date-parts":[[2016,10,6]],"date-time":"2016-10-06T22:28:53Z","timestamp":1475792933000},"page":"1092-1103","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":76,"title":["Influence of female sex and fertile age on neuromyelitis optica spectrum disorders"],"prefix":"10.1177","volume":"23","author":[{"given":"Nadja","family":"Borisow","sequence":"first","affiliation":[{"name":"NeuroCure Clinical Research Center and Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charit\u00e9 University Medicine Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingo","family":"Kleiter","sequence":"additional","affiliation":[{"name":"Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Gahlen","sequence":"additional","affiliation":[{"name":"Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Neurology, Asklepios Fachklinikum Teupitz, Teupitz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus-Dieter","family":"Wernecke","sequence":"additional","affiliation":[{"name":"CRO SOSTANA GmbH and Charit\u00e9 University Medicine Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Pache","sequence":"additional","affiliation":[{"name":"NeuroCure Clinical Research Center and Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charit\u00e9 University Medicine Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klemens","family":"Ruprecht","sequence":"additional","affiliation":[{"name":"Department of Neurology and Clinical and Experimental Multiple Sclerosis Research Center, Charit\u00e9 University Medicine Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Havla","sequence":"additional","affiliation":[{"name":"Institute of Clinical Neuroimmunology, Medical Campus Grosshadern, Ludwig Maximilians University of Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Krumbholz","sequence":"additional","affiliation":[{"name":"Institute of Clinical Neuroimmunology, Medical Campus Grosshadern, Ludwig Maximilians University of Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"K\u00fcmpfel","sequence":"additional","affiliation":[{"name":"Institute of Clinical Neuroimmunology, Medical Campus Grosshadern, Ludwig Maximilians University of Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orhan","family":"Aktas","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Faculty, Heinrich Heine University D\u00fcsseldorf, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius","family":"Ringelstein","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Faculty, Heinrich Heine University D\u00fcsseldorf, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Geis","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital of W\u00fcrzburg, W\u00fcrzburg, Germany\/Hans-Berger Department of Neurology and Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Kleinschnitz","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Essen, Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achim","family":"Berthele","sequence":"additional","affiliation":[{"name":"Department of Neurology, Klinikum rechts der Isar, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Hemmer","sequence":"additional","affiliation":[{"name":"Department of Neurology, Klinikum rechts der Isar, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany\/Munich Cluster for Systems Neurology (SyNergy), Technische Universit\u00e4t M\u00fcnchen, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klemens","family":"Angstwurm","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Regensburg, Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Weissert","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Regensburg, Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Patrick","family":"Stellmann","sequence":"additional","affiliation":[{"name":"Institute of Neuroimmunology and MS (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany\/Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Schuster","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Stangel","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroimmunology and Neurochemistry and Department of Neurology, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Lauda","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Ulm, Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayrettin","family":"Tumani","sequence":"additional","affiliation":[{"name":"Department of Neurology at RKU and Specialty Clinic of Neurology Dietenbronn, University of Ulm, Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Mayer","sequence":"additional","affiliation":[{"name":"Department of Neurology, Goethe University Frankfurt, Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Zeltner","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke and Hertie Institute for Clinical Brain Research, University of T\u00fcbingen, T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulf","family":"Ziemann","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke and Hertie Institute for Clinical Brain Research, University of T\u00fcbingen, T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf A","family":"Linker","sequence":"additional","affiliation":[{"name":"Department of Neurology, Friedrich-Alexander University Erlangen-N\u00fcremberg, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Schwab","sequence":"additional","affiliation":[{"name":"Hans-Berger Department of Neurology, Jena University Hospital, Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Marziniak","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of M\u00fcnster, M\u00fcnster, Germany\/Department of Neurology and Neurological Intensive Care, Isar-Amper-Clinic, Munich-East, Haar, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Then Bergh","sequence":"additional","affiliation":[{"name":"Department of Neurology, Leipzig University, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Hofstadt-van Oy","sequence":"additional","affiliation":[{"name":"Department of Neurology, Klinikum Bayreuth, Bayreuth, Germany\/Department of Neurology, Klinikum Westfalen, Dortmund, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Neuhaus","sequence":"additional","affiliation":[{"name":"Department of Neurology, SRH Krankenhaus Sigmaringen, Sigmaringen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Winkelmann","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Rostock, Rostock, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wael","family":"Marouf","sequence":"additional","affiliation":[{"name":"Department of Neurology, HELIOS Hanseklinikum Stralsund, Stralsund, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lioba","family":"R\u00fcckriem","sequence":"additional","affiliation":[{"name":"Department of Neurology, MediClin Hedon Klinik, Lingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Faiss","sequence":"additional","affiliation":[{"name":"Department of Neurology, Asklepios Fachklinikum Teupitz, Teupitz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte","family":"Wildemann","sequence":"additional","affiliation":[{"name":"Department of Neurology, Heidelberg University, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedemann","family":"Paul","sequence":"additional","affiliation":[{"name":"NeuroCure Clinical Research Center and Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charit\u00e9 University Medicine Berlin, Berlin, Germany\/Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charit\u00e9 University Medicine Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Jarius","sequence":"additional","affiliation":[{"name":"Department of Neurology, Heidelberg University, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinna","family":"Trebst","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Hellwig","sequence":"additional","affiliation":[{"name":"Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of NEMOS (Neuromyelitis Optica Study Group)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,10,6]]},"reference":[{"key":"bibr1-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1111\/cei.12271"},{"key":"bibr2-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2009.08.045"},{"key":"bibr3-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2012.314"},{"key":"bibr4-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1186\/1742-2094-9-14"},{"key":"bibr5-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2014.03.033"},{"key":"bibr6-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000049912.02954.2C"},{"key":"bibr7-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60128-8"},{"key":"bibr8-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1016\/j.clim.2013.03.005"},{"key":"bibr9-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1016\/S0074-7742(07)79017-7"},{"key":"bibr10-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000216139.44259.74"},{"key":"bibr11-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(07)70216-8"},{"key":"bibr12-1352458516671203","volume-title":"Birth trends and the family situation in Germany","author":"Poetzsch O","year":"2012"},{"key":"bibr13-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2013.02.008"},{"key":"bibr14-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24554"},{"key":"bibr15-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1002\/bimj.200310018"},{"key":"bibr16-1352458516671203","first-page":"731","volume":"30","author":"Alamanos Y","year":"2003","journal-title":"J Rheumatol"},{"key":"bibr17-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12327"},{"key":"bibr18-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1177\/1352458511417479"},{"key":"bibr19-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000314832.24682.c6"},{"key":"bibr20-1352458516671203","first-page":"672","volume":"17","author":"Uzawa A","year":"2010","journal-title":"Eur J Neurol Off J Eur Fed Neurol Soc"},{"key":"bibr21-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2011.216"},{"key":"bibr22-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-013-7169-7"},{"key":"bibr23-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1191\/0961203303lu469xx"},{"key":"bibr24-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1177\/0961203313490432"},{"key":"bibr25-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-010-5780-4"},{"key":"bibr26-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181fc2823"},{"key":"bibr27-1352458516671203","doi-asserted-by":"publisher","DOI":"10.2174\/156652409789839116"},{"key":"bibr28-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1562\/2005-02-15-IR-441"},{"key":"bibr29-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2012.43"},{"key":"bibr30-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1321060111"},{"key":"bibr31-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1007\/BF03401300"},{"key":"bibr32-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1006\/clin.1993.1026"},{"key":"bibr33-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1016\/j.cellimm.2015.01.018"},{"key":"bibr34-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1177\/1352458514528762"},{"key":"bibr35-1352458516671203","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000234031.30756.a0"}],"container-title":["Multiple Sclerosis Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1352458516671203","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1352458516671203","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1352458516671203","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T03:48:22Z","timestamp":1777693702000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1352458516671203"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10,6]]},"references-count":35,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2017,7]]}},"alternative-id":["10.1177\/1352458516671203"],"URL":"https:\/\/doi.org\/10.1177\/1352458516671203","relation":{},"ISSN":["1352-4585","1477-0970"],"issn-type":[{"value":"1352-4585","type":"print"},{"value":"1477-0970","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,10,6]]}}}