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Worldwide prevalence of neuromyelitis optica spectrum disorder (NMOSD) and neuromyelitis optica (NMO): a systematic review and meta-analysis

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Abstract

Background

Neuromyelitis optica spectrum disorder (NMOSD) is a progressive demyelinating disease of the central nervous system that has overlapping symptoms with multiple sclerosis (MS) but differs from it in a variety of ways. Previous studies have reported conflicting results trying to estimate the number of individuals affected by them which is why we designed this systematic review and meta-analysis to estimate the worldwide prevalence and incidence of NMOSD/NMO based on current evidence.

Methods

We searched PubMed, Scopus, EMBASE, Web of Science, and gray literature including references from the identified studies, review studies, and conference abstracts which were published up to February 1, 2022. We used all MeSH terms pertaining to “NMOSD,” “NMO,” and all the terms on “prevalence,” “incidence,” and “epidemiology” to identify the search components. Pooled effect sizes were measured using random-effect model by DerSimonian-Laird.

Results

The prevalence and incidence rates of NMOSD/NMO ranged from 0.07 to 10 and 0.029 to 0.880 per 100,000 population, respectively. The overall pooled prevalence of NMO per 100,000 population was 1.54 (I2: 98.4%, 95% CI: 1.13–1.96, P< 0.001) based on the 2006 criteria, 1.51 (I2: 99.4%, 95% CI: 1.21–1.81, P < 0.001) based on the 2015 criteria and 2.16 (I2: 89.4%, 95% CI: 1.46–2.86, P < 0.001) based on the 2006/2015 criteria. The overall annual incidence of NMO per 100,000 population was 0.155 (I2: 95%, 95% CI: 0.115–0.195, P < 0.001) based on the 2006 criteria and 0.278 (I2: 100%, 95% CI: 0.135–0.420, P < 0.001) based on the 2015 criteria. The prevalence rates were highest in French West Indies and South Korea, and lowest in Cuba and Australia, based on the 2006 and 2015 criteria, respectively. Also, the highest annual incidence rates were obtained for Sweden and Slovak republic and the lowest for Cuba and Australia based on the 2006 and 2015 criteria, respectively. All estimated rates were higher among females compared to males.

Conclusion

Although rare, NMOSD/NMO impact affected individuals in devastating ways. Several large-scale prospective studies are required to reach a comprehension of the epidemiological aspects of these notorious demyelinating conditions.

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Data availability

All of the data will be available for secondary analysis in necessary cases from the corresponding author through an email address.

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Authors and Affiliations

  1. Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

    Sara Bagherieh, Saeed Vaheb, Mahsa Kiani, Elham Moases Ghaffary, Mahdi Barzegar, Vahid Shaygannejad & Omid Mirmosayyeb

  2. Department of Biostatistics and Epidemiology, Faculty of Health, North Khorasan University of Medical Sciences, Bojnurd, Iran

    Alireza Afshari-Safavi

  3. Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

    Mahdi Barzegar, Vahid Shaygannejad & Omid Mirmosayyeb

  4. Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH, USA

    Aram Zabeti

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Contributions

Conceptualization: O. M.

Data curation: O. M., A. A. S.

Formal analysis: O. M., A. A. S.

Funding acquisition: Not applicable.

Investigation: S. V., M. K., S. B.

Methodology: O. M., S. V., M. K., M. B., S. B.

Project administration: O. M.

Supervision: O. M.

Validation: O. M., A. A. S, VSh.

Visualization: O. M., A. A. S.

Writing—original draft: S. B.

Writing—review and editing: O. M., S. V., EMGh, A. Z., M. B., S. B.

We declare that all co-authors have read and approved the submission.

Corresponding author

Correspondence to Omid Mirmosayyeb.

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Bagherieh, S., Afshari-Safavi, A., Vaheb, S. et al. Worldwide prevalence of neuromyelitis optica spectrum disorder (NMOSD) and neuromyelitis optica (NMO): a systematic review and meta-analysis. Neurol Sci 44, 1905–1915 (2023). https://doi.org/10.1007/s10072-023-06617-y

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