{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T22:50:37Z","timestamp":1782168637320,"version":"3.54.5"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T00:00:00Z","timestamp":1611532800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T00:00:00Z","timestamp":1611532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81901229"],"award-info":[{"award-number":["81901229"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81771300"],"award-info":[{"award-number":["81771300"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81971140"],"award-info":[{"award-number":["81971140"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Guangdong Basic and Applied Basic Research Foundation","award":["2019A1515010297"],"award-info":[{"award-number":["2019A1515010297"]}]},{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2017A030313853"],"award-info":[{"award-number":["2017A030313853"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Guangzhou Science and Technology Plan Project","award":["201904010444"],"award-info":[{"award-number":["201904010444"]}]},{"name":"High-level Hospital Construction Research Project of Maoming People\u2019s Hospital"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Neurol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early stage neuromyelitis optica spectrum disorders (NMOSD) with non-opticospinal manifestations as initial symptoms are easily misdiagnosed; however, data on the full symptom profile are limited. Moreover, the clinical characteristics and long-term outcomes of these patients remain unknown. We sought to analyze the clinical characteristics, imaging features, and long-term outcomes of NMOSD with non-opticospinal manifestations as initial symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively included relevant patients from our center. Clinical, demographic, magnetic resonance imaging, treatment, and outcome data were compared according to the non-opticospinal vs. opticospinal initial symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified 43 (9.13\u2009%) patients with non-opticospinal initial symptoms among 471 patients with NMOSD. Of these, 88.37\u2009% developed optic neuritis\/myelitis during an average follow-up period of 6.33\u00a0years. All the non-opticospinal symptoms were brain\/brainstem symptoms. Most of the symptoms and associated brain lesions were reversible. These patients had a younger onset age (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), lower serum aquaporin-4 (AQP4) antibody titers (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.030), and a lower Expanded Disability Status Scale (EDSS) score at onset (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and follow-up (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.041) than NMOSD patients with opticospinal initial symptoms. In addition, EDSS scores reached 3.0 (indicating moderate disability) later than in patients with opticospinal initial symptoms (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.028).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with NMOSD with non-opticospinal initial symptoms have a younger onset age, lower serum AQP4 antibody titers, and better clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12883-021-02059-1","type":"journal-article","created":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T02:04:48Z","timestamp":1611540288000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Neuromyelitis optica spectrum disorders with non opticospinal manifestations as initial symptoms: a long-term observational study"],"prefix":"10.1186","volume":"21","author":[{"given":"Rui","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danli","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuge","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaqing","family":"Shu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyu","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaobo","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengqi","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6805-3841","authenticated-orcid":false,"given":"Zhi","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,1,25]]},"reference":[{"key":"2059_CR1","unstructured":"Devic E. My\u00e9lite aigu\u00eb dorso-lombaire avec n\u00e9vrite optique, Autopsie. Congr\u00e8s fran\u00e7ais de m\u00e9decine. 1895:434\u20139."},{"key":"2059_CR2","unstructured":"Gault F. De la neuromy\u00e9lite optique aigu\u00eb. 1894."},{"key":"2059_CR3","doi-asserted-by":"publisher","first-page":"2106","DOI":"10.1016\/S0140-6736(04)17551-X","volume":"364 9451","author":"VA Lennon","year":"2004","unstructured":"Lennon VA, Wingerchuk DM, Kryzer TJ, Pittock SJ, Lucchinetti CF, Fujihara K, et al. A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis. Lancet. 2004;364 9451:2106\u201312. doi:https:\/\/doi.org\/10.1016\/S0140-6736(04)17551-X.","journal-title":"Lancet"},{"key":"2059_CR4","doi-asserted-by":"publisher","first-page":"1485","DOI":"10.1212\/01.wnl.0000216139.44259.74","volume":"66 10","author":"DM Wingerchuk","year":"2006","unstructured":"Wingerchuk DM, Lennon VA, Pittock SJ, Lucchinetti CF, Weinshenker BG. Revised diagnostic criteria for neuromyelitis optica. Neurology. 2006;66 10:1485\u20139. doi:https:\/\/doi.org\/10.1212\/01.wnl.0000216139.44259.74.","journal-title":"Neurology"},{"issue":"10 Supplement","key":"2059_CR5","doi-asserted-by":"crossref","first-page":"63-001","DOI":"10.1212\/WNL.82.10_supplement.S63.001","volume":"82","author":"DM Wingerchuk","year":"2014","unstructured":"Wingerchuk DM, Banwell B, Bennett JL, Cabre P, Carroll W, Chitnis T, et al. Revised diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. 2014;82(10 Supplement):63-001.","journal-title":"Neurology"},{"key":"2059_CR6","doi-asserted-by":"publisher","unstructured":"Lana-Peixoto MA, Talim N. Neuromyelitis Optica Spectrum Disorder and Anti-MOG Syndromes. 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Written informed consent was obtained from each patient.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"35"}}