Highlights
- •CNS inflammatory demyelinating diseases (CNSIDDs) are rare in Thailand.
- •NMOSD was the most prevalent CNSIDD at 3.33 per 100,000 persons.
- •NMOSD caused the highest disease burden among CNSIDDs in Thailand.
- •The prevalence of MS was 0.77 per 100,000 persons.
- •The prevalence of MOGAD in adults was 0.51 per 100,000 persons.
Abstract
Background
Central nervous system inflammatory demyelinating diseases (CNSIDDs) have notable
interracial heterogeneity. The epidemiology of CNSIDDs in Thailand, a mainland Southeast
Asian country, is unknown.
Objectives
To determine the cumulative incidence, point prevalence, and disease burden of neuromyelitis
optica spectrum disorder (NMOSD) and other CNSIDDs in Thailand using population-based
data of Chumphon.
Methods
Searching for CNSIDD patients at a public secondary care hospital in Chumphon, the
only neurology center in the province, from January 2016 to December 2021 was implemented
using relevant ICD-10-CM codes. All diagnoses were individually ascertained by a retrospective
chart review. Cumulative incidence, point prevalence, attack rate, mortality rate,
and disability-adjusted life years (DALYs) were calculated.
Results
Aquaporin 4-IgG-positive NMOSD was the most prevalent CNSIDD in the Thai population
at 3.08 (1.76–5.38) per 100,000 persons. The prevalence of multiple sclerosis (MS)
followed at 0.77 (0.26–2.26) and myelin oligodendrocyte glycoprotein antibody-associated
disease (MOGAD) at 0.51(0.14–1.87) per 100,000 adults. In the pediatric population,
the incidence of acute disseminated encephalomyelitis was 0.28 (0.08–1.02) per 100,000
persons/year. Among other idiopathic demyelinating diseases, idiopathic optic neuritis
had the highest incidence at 0.58 (0.24–0.92) per 100,000 persons/year, followed by
acute transverse myelitis at 0.44 (0.14–0.74). Idiopathic demyelinating brainstem
syndrome was also observed at 0.04 (0.01–0.25) per 100,000 persons/year. Although
most had a fair recovery, disability was worst among NMOSD patients with DALYs of
3.61 (3.00–4.36) years per 100,000 persons. Mortality rate was the highest in NMOSD
as well.
Conclusion
CNSIDDs are rare diseases in Thailand. The prevalence is comparable to that of East
Asian populations. A nationwide CNSIDDs registry would better elaborate the epidemiology
of these diseases.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Multiple Sclerosis and Related DisordersAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Modern Look at Transverse Myelitis and Inflammatory Myelopathy: Epidemiology of the National Veterans Health Administration Population.Neurol. Neuroimmunol. Neuroinflamm. 2021; 8e1071
- Race and ethnicity on MS presentation and disease course.Mult. Scler. 2020; 26: 561-567
- WHO Methods and Data Sources For Global Burden of Disease Estimates 2000-2019.World Health Organization, 2020 (Department of Data and Analytics DoD, Analytics and Delivery for Impact2020 December)
- Newly diagnosed neuromyelitis optica spectrum disorders following vaccination: case report and systematic review.Mult. Scler. Relat. Disord. 2022; 58103414
- Disability and health status: ethnic differences among women in the United States.J. Epidemiol. Community Health. 2000; 54: 200-206
- Clinical features of COVID-19 on patients with neuromyelitis optica spectrum disorders.Neurol. Neuroimmunol. Neuroinflammation. 2021; 8: e1060
- Incidence of acquired demyelination of the CNS in Canadian children.Neurology. 2009; 72: 232-239
- Development of the standards of reporting of neurological disorders (STROND) checklist: a guideline for the reporting of incidence and prevalence studies in neuroepidemiology.Eur. J. Epidemiol. 2015; 30: 569-576
- The epidemiology of transverse myelitis.Autoimmun. Rev. 2010; 9: A395-A3A9
- Pediatric-onset multiple sclerosis and other acquired demyelinating syndromes of the central nervous system in Denmark during 1977–2015: a nationwide population-based incidence study.Mult. Scler. J. 2018; 24: 1077-1086
- Trends in optic neuritis incidence and prevalence in the UK and association with systemic and neurologic disease.JAMA Neurol. 2020; 77: 1514-1523
- Global, regional, and national burden of multiple sclerosis 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.Lancet Neurol. 2019; 18: 269-285
- The clinical spectrum and incidence of anti-MOG-associated acquired demyelinating syndromes in children and adults.Mult. Scler. 2020; 26: 806-814
- mRNA COVID-19 vaccines do not increase the short-term risk of clinical relapses in multiple sclerosis.J. Neurol. Neurosurg. Psychiatry. 2022; 93: 448-450
- Risk of disease relapse following COVID-19 vaccination in patients with AQP4-IgG-positive NMOSD and MOGAD.Mult. Scler. Relat. Disord. 2022; 58103424
- Does COVID-19 increase the long-term relapsing-remitting multiple sclerosis clinical activity? A cohort study.BMC Neurol. 2022; 22: 64
- Global, regional, and national burden of neurological disorders, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016.Lancet Neurol. 2019; 18: 459-480
- Epidemiology of aquaporin-4 autoimmunity and neuromyelitis optica spectrum.Ann. Neurol. 2016; 79: 775-783
- The epidemiology of myelin oligodendrocyte glycoprotein antibody associated disorders.Mult. Scler. Journal. 2019; (ECTRIMS 2019): 160
- MOG antibody-associated disease after vaccination with ChAdOx1 nCoV-19.Lancet Neurol. 2022; 21: 217-218
- Proposed diagnostic criteria and nosology of acute transverse myelitis.Neurology. 2002; 59: 499-505
- Review of disability weight studies: comparison of methodological choices and values.Popul. Health Metr. 2014; 12: 20
- Population-based incidence of optic neuritis in the era of aquaporin-4 and myelin oligodendrocyte glycoprotein antibodies.Am. J. Ophthalmol. 2020; 220: 110-114
- Epidemiology of neuromyelitis optica spectrum disorder and its prevalence and incidence worldwide.Front. Neurol. 2020; 11
- Prevalence of neuromyelitis optica spectrum disorder in the multi-ethnic Penang Island, Malaysia, and a review of worldwide prevalence.Mult. Scler. Relat. Disord. 2018; 19: 20-24
- Predictors of relapse in MOG antibody associated disease: a cohort study.BMJ Open. 2021; 11e055392
- Standardized method for the detection of antibodies to aquaporin-4 based on a highly sensitive immunofluorescence assay employing recombinant target antigen.J. Neurol. Sci. 2010; 291: 52-56
- MOG encephalomyelitis: international recommendations on diagnosis and antibody testing.J Neuroinflammation. 2018; 15: 134
- Racial differences in neuromyelitis optica spectrum disorder.Neurology. 2018; 91: e2089-e2e99
- International Pediatric Multiple Sclerosis Study Group criteria for pediatric multiple sclerosis and immune-mediated central nervous system demyelinating disorders: revisions to the 2007 definitions.Mult. Scler. J. 2013; 19: 1261-1267
- Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS).Neurology. 1983; 33: 1444-1452
- Association of MOG-IgG serostatus with relapse after acute disseminated encephalomyelitis and proposed diagnostic criteria for MOG-IgG–associated disorders.JAMA Neurol. 2018; 75: 1355-1363
- Vaccines and the risk of multiple sclerosis and other central nervous system demyelinating diseases.JAMA Neurol. 2014; 71: 1506-1513
- Prevalence and incidence of neuromyelitis optica spectrum disorder in Korea: population based study.J. Korean Med. Sci. 2020; 35 (-e): e115
- Population-based Incidence of pediatric and adult optic neuritis and the risk of multiple sclerosis.Ophthalmology. 2020; 127: 417-425
- HLA, molecular mimicry and multiple sclerosis.Rev. Immunogenet. 2000; 2: 95-104
- High titers of myelin oligodendrocyte glycoprotein antibody are only observed close to clinical events in pediatrics.Mult. Scler. Relat. Disord. 2021; 56
- Is there a correlation between MOG-associated disorder and SARS-CoV-2 infection?.Eur J Neurol. 2022 Jun; 29: 1855-1858
- Vaccines and the association with relapses in patients with neuromyelitis optica spectrum disorder.Mult. Scler. Relat. Disord. 2018; 23: 78-82
- Nationwide epidemiological study of neuromyelitis optica in Japan.J. Neurol. Neurosurg. Psychiatry. 2018; 89: 667-668
- Global Burden of Disease Study 2019 (GBD 2019) Reference Life Table.Institute for Health Metrics and Evaluation (IHME, 2021
- Case report: multiple sclerosis relapses after vaccination against SARS-CoV2: a series of clinical cases.Front. Neurol. 2021; 12
- Worldwide incidence and prevalence of neuromyelitis optica.Syst. Rev. 2021; 96: 59-77
- Diagnosis and classification of optic neuritis.Lancet Neurol. 2022; 21: 1120-1134
- Acute disseminated encephalomyelitis: Updates on an inflammatory CNS syndrome.Neurology. 2016; 87: S38-45
Prayoonwiwat N, Apiwattanakul M, Pasogpakdee P, et al. Prevalence of idiopathic inflammatory demyelinating central nervous system disorders in Thailand. Taipei, Taiwan: PACTRIM; 2014.
- The latitude gradient for multiple sclerosis prevalence is established in the early life course.Brain. 2021; 144: 2038-2046
- Disability weights for the Global Burden of Disease 2013 study.Lancet Glob. Health. 2015; 3: e712-ee23
- Factors associated with relapse and treatment of myelin oligodendrocyte glycoprotein antibody–associated disease in the United Kingdom.JAMA Netw. Open. 2022; 5 (-e)e2142780
- Aquaporin-4 and MOG autoantibody discovery in idiopathic transverse myelitis epidemiology.Neurology. 2019; 93: e414-ee20
- Positive predictive value of myelin oligodendrocyte glycoprotein autoantibody testing.JAMA Neurol. 2021; 78: 741-746
- Seroprevalence and clinical phenotype of MOG-IgG-associated disorders in Sri Lanka.J. Neurol. Neurosurg. Psychiatry. 2019; 90: 1381-1383
- Latitude continues to be significantly associated with the prevalence of multiple sclerosis: an updated meta-analysis.J. Neurol. Neurosurg. Psychiatry. 2019; 90: 1193-1200
- Increasing incidence and prevalence of multiple sclerosis in the Greater Hobart cohort of Tasmania, Australia.J. Neurol. Neurosurg. Psychiatry. 2022; 93: 723-731
- AQP4 antibody-positive Thai cases: clinical features and diagnostic problems.Neurology. 2011; 77: 827-834
- Health utilities of patients with multiple sclerosis and neuromyelitis optica spectrum disorders in Thailand.Mult. Scler. Relat. Disord. 2018; 24: 151-156
- Asian and African/Caribbean AQP4-NMOSD patient outcomes according to self-identified race and place of residence.Mult. Scler. Relat. Disord. 2021; 53103080
- Incidence and causes of overdiagnosis of optic neuritis.JAMA Ophthalmol. 2018; 136: 76-81
- Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria.Lancet Neurol. 2018; 17: 162-173
- Incidence of neuromyelitis optica spectrum disorder (NMOSD) in China: a national population-based study.Lancet Reg. Health West. Pac. 2020; 2100021
- A quarter-century report on neuromyelitis optica spectrum disorder in Thailand: a single-center tertiary care cohort.Mult. Scler. Relat. Disord. 2022; 63103907
- Rising prevalence of multiple sclerosis worldwide: insights from the Atlas of MS, third edition.Mult. Scler. 2020; 26: 1816-1821
- A multicenter comparison of MOG-IgG cell-based assays.Neurology. 2019; 92: e1250-e12e5
- International consensus diagnostic criteria for neuromyelitis optica spectrum disorders.Neurology. 2015; 85: 177-189
- Incidence and mortality of acute disseminated encephalomyelitis in china: a nationwide population-based study.Neurosci. Bull. 2021; 37: 804-808
Article info
Publication history
Published online: January 06, 2023
Accepted:
January 5,
2023
Received in revised form:
January 4,
2023
Received:
August 17,
2022
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.
