{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:34:32Z","timestamp":1792787672768,"version":"4.5.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"11-12","license":[{"start":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T00:00:00Z","timestamp":1726012800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Multiple Sclerosis Canada","award":["EGID 918124"],"award-info":[{"award-number":["EGID 918124"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>It is unknown whether people with aquaporin-4 antibody positive (AQP4-IgG+) neuromyelitis optica spectrum disorder (NMOSD) experience a prodrome, although a few cases report AQP4 + serology up to 16 years before the first attack.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate whether individuals with AQP4-IgG + NMOSD have prodromal neurologic symptoms preceding the first attack.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We reviewed medical records of participants meeting the 2015 diagnostic criteria for AQP4-IgG + NMOSD from four demyelinating disease centres in the Canadian NMOSD cohort study CANOPTICS. We searched for neurologic symptoms occurring at least 30 days before the first attack.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 116 participants with NMOSD, 17 (14.7%) had prodromal neurologic symptoms. The median age was 48 years (range 25\u201383) at first attack; 16 (94.1%) were female. Participants presented with numbness\/tingling ( n = 9), neuropathic pain ( n = 5), visual disturbance ( n = 4), tonic spasms ( n = 2), Lhermitte sign ( n = 2), severe headache ( n = 2), incoordination ( n = 2), weakness ( n = 1), psychosis ( n = 1) or seizure ( n = 1). Of eight who underwent magnetic resonance imaging (MRI) brain, orbits and\/or spinal cord, five had T2 lesions. Within 1.5\u2013245 months (median 14) from the onset of prodromal neurologic symptoms, participants experienced their first NMOSD attack.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>One in seven people with NMOSD experienced neurologic symptoms before their first attack. Further investigation of a possible NMOSD prodrome is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585241275491","type":"journal-article","created":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T21:32:54Z","timestamp":1726263174000},"page":"1423-1435","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Is there a prodrome to NMOSD? An investigation of neurologic symptoms preceding the first NMOSD attack"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8591-2062","authenticated-orcid":false,"given":"Sydney","family":"Lee","sequence":"first","affiliation":[{"name":"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 Internal Medicine and Community Health Sciences, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Fadda","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Neurology, University of Ottawa, Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark S","family":"Freedman","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Neurology, University of Ottawa, Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liesly","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Muccilli","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, BARLO MS Centre, St. Michael\u2019s Hospital, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2953-2540","authenticated-orcid":false,"given":"Manav V","family":"Vyas","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, BARLO MS Centre, St. Michael\u2019s Hospital, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Konig","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, BARLO MS Centre, St. Michael\u2019s Hospital, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalia L.","family":"Rotstein","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, BARLO MS Centre, St. Michael\u2019s Hospital, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,9,11]]},"reference":[{"key":"bibr1-13524585241275491","doi-asserted-by":"publisher","DOI":"10.1002\/mds.24996"},{"key":"bibr2-13524585241275491","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21509"},{"key":"bibr3-13524585241275491","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurol.2023.07.002"},{"key":"bibr4-13524585241275491","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.761408"},{"key":"bibr5-13524585241275491","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25247"},{"key":"bibr6-13524585241275491","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-021-00519-3"},{"key":"bibr7-13524585241275491","doi-asserted-by":"publisher","DOI":"10.1177\/1352458514554054"},{"key":"bibr8-13524585241275491","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24769"},{"key":"bibr9-13524585241275491","doi-asserted-by":"publisher","DOI":"10.1177\/1352458520914844"},{"key":"bibr10-13524585241275491","doi-asserted-by":"publisher","DOI":"10.1080\/14737175.2020.1746645"},{"key":"bibr11-13524585241275491","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2019.3238"},{"key":"bibr12-13524585241275491","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001729"},{"key":"bibr13-13524585241275491","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20050304"},{"key":"bibr14-13524585241275491","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182a6cb5c"},{"key":"bibr15-13524585241275491","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181a82621"},{"key":"bibr16-13524585241275491","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31825644ff"},{"key":"bibr17-13524585241275491","doi-asserted-by":"publisher","DOI":"10.1177\/13524585221074947"},{"key":"bibr18-13524585241275491","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000000104"},{"key":"bibr19-13524585241275491","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000224"},{"key":"bibr20-13524585241275491","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000334"},{"key":"bibr21-13524585241275491","doi-asserted-by":"publisher","DOI":"10.1177\/17562864211014389"},{"key":"bibr22-13524585241275491","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.966428"},{"key":"bibr23-13524585241275491","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.53.5.1107"},{"key":"bibr24-13524585241275491","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2022.103697"},{"key":"bibr25-13524585241275491","first-page":"6151258","volume":"2020","author":"Turco 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