{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:34:56Z","timestamp":1792787696762,"version":"4.5.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"MS Canada","award":["EGID 918124"],"award-info":[{"award-number":["EGID 918124"]}]},{"name":"CMSC"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Prodromal phases are well recognized in many inflammatory and neurodegenerative diseases, including multiple sclerosis. We evaluated the possibility of a prodrome in aquaporin-4 antibody positive (AQP4+) neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody disease (MOGAD) using health administrative data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We investigated individuals with AQP4 + NMOSD and MOGAD, confirmed by medical chart review, in Ontario, Canada. Each NMOSD and MOGAD participant was matched 1:5 to general population controls by sex, birth year, immigrant status, and region. Total outpatient visits and hospitalizations were compared in the 5 years preceding the incident attack in multivariable negative binomial models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We identified 96 people with AQP4 + NMOSD, matched to 479 controls, and 61 people with MOGAD, matched to 303 controls. In the 5 years preceding the incident attack, health care use was elevated for outpatient visits and hospitalizations for the NMOSD cohort (adjusted rate ratio (aRR): 1.47; 95% confidence interval (CI): 1.25\u20131.73; aRR: 1.67; 95% CI: 1.19\u20132.36, respectively) but not for MOGAD. Rate ratios steadily increased in NMOSD for outpatient visits in the 2 years preceding the incident attack.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our findings support a prodromal phase preceding clinical onset of AQP4 + NMOSD. Earlier recognition and management of NMOSD patients may be possible.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585241272939","type":"journal-article","created":{"date-parts":[[2024,9,7]],"date-time":"2024-09-07T00:34:50Z","timestamp":1725669290000},"page":"1331-1340","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Investigation of health care use and a possible prodrome before the first attack in NMOSD and MOGAD"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7280-3684","authenticated-orcid":false,"given":"Dalia L","family":"Rotstein","sequence":"first","affiliation":[{"name":"St. Michael\u2019s Hospital, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark S","family":"Freedman","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Konig","sequence":"additional","affiliation":[{"name":"St. Michael\u2019s Hospital, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liesly","family":"Lee","sequence":"additional","affiliation":[{"name":"Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Luo","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen","family":"Maxwell","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; School of Pharmacy, University of Waterloo, Waterloo, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7522-6440","authenticated-orcid":false,"given":"Sarah A","family":"Morrow","sequence":"additional","affiliation":[{"name":"Western University, London, ON, Canada; University of Calgary, Calgary, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5804-2535","authenticated-orcid":false,"given":"Helen","family":"Tremlett","sequence":"additional","affiliation":[{"name":"Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manav V","family":"Vyas","sequence":"additional","affiliation":[{"name":"St. Michael\u2019s Hospital, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1855-5595","authenticated-orcid":false,"given":"Ruth Ann","family":"Marrie","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada"},{"name":"Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,9,5]]},"reference":[{"key":"bibr1-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-022-00686-x"},{"key":"bibr2-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-021-00519-3"},{"key":"bibr3-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30076-5"},{"key":"bibr4-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25247"},{"key":"bibr5-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001729"},{"key":"bibr6-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(22)00431-8"},{"key":"bibr7-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1002\/cti2.1316"},{"key":"bibr8-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(12)70133-3"},{"key":"bibr9-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000203903"},{"key":"bibr10-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31825644ff"},{"key":"bibr11-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181a82621"},{"key":"bibr12-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1177\/1352458514522103"},{"key":"bibr13-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1080\/00207454.2019.1579718"},{"key":"bibr14-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1177\/13524585221074947"},{"key":"bibr15-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000924"},{"key":"bibr16-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1177\/13524585231151953"},{"key":"bibr17-13524585241272939","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.01028"},{"key":"bibr18-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21837"},{"key":"bibr19-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1177\/1352458513503053"},{"key":"bibr20-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26067"},{"key":"bibr21-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1177\/13524585231172145"},{"key":"bibr22-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000206313"},{"key":"bibr23-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1186\/s12974-016-0718-0"},{"key":"bibr24-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2020.101965"},{"key":"bibr25-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2021.103463"},{"key":"bibr26-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1007\/s13365-022-01065-4"},{"key":"bibr27-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2021.103286"},{"key":"bibr28-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(22)00043-6"},{"key":"bibr29-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2023.104802"},{"key":"bibr30-13524585241272939","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2018.11.008"}],"container-title":["Multiple 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