{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:32:18Z","timestamp":1791804738756,"version":"4.3.4"},"reference-count":15,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100002429","name":"Amgen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002429","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Sumaira Foundation"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To assess loss of employment, work hours, and wages of people with aquaporin-4 antibody-positive or double-seronegative\/antibody status unknown neuromyelitis optica spectrum disorder (NMOSD) internationally.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>An investigator-designed survey was administered to adults ages 18\u201370 years with NMOSD and distributed by neurologists in 23 countries, July 2022 to September 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      There were 897 participants (635 aquaporin-4 antibody positive, 262 double-seronegative\/untested; 81.4% female, average age 42.5 years, average disease duration 7.6 years, median 2 disease attacks since diagnosis). NMOSD impact was visual loss (34.0% unilateral; 28.2% bilateral), 61.8% with spinal cord disease, 55.6% with pain, 43.6% with fatigue, 38.2% with depressed mood, and 25.0% with gait aid use. In total, 92.6% took immunosuppressive therapy. Employment rates were 62.6% before and 36.3% after NMOSD diagnosis. In a multivariable model, statistically significant independent associations with unemployment in NMOSD were older age (odds ratio (OR) = 0.97,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), being female (OR = 0.48,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), bilateral visual loss (OR = 0.61,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.02), highest frequency of depressed mood (OR = 0.29,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), and walking aid use (OR = 0.38,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>Approximately 1\/3 of people living with NMOSD of potential working age are in the workforce. Unemployment in NMOSD is associated with previously recognized factors but also self-reported low mood, gait aid use, and bilateral visual loss.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585251349139","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T12:13:28Z","timestamp":1752063208000},"page":"1358-1369","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Unemployment, work hour reduction, and income loss: An international, multicentered, cross-sectional study of neuromyelitis optica spectrum disorder"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9426-897X","authenticated-orcid":false,"given":"Andrew Siyoon","family":"Ham","sequence":"first","affiliation":[{"name":"Neurology, Massachusetts General Hospital, Boston, MA, 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