Evaluation of types of psychological disorders in patients with neuromyelitis optica spectrum disorder (NMOSD)

Ebadi, Zahra; Saeedi, Roghayyeh; Hashemi, Seyedeh Nafiseh; Gheini, Mohammad Reza; Sahraian, Mohammad Ali; Moghadasi, Abdorreza Naser

doi:10.1016/j.msard.2020.102128

Cited by 8 publications

(4 citation statements)

References 16 publications

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“…Findings from focus groups, individual interviews, and standardized self-report measures, suggest a more complex and nuanced psychological burden among patients with NMOSD and their caregiver/loved ones than that described in empirical literature to date. Nearly three quarters of NMOSD patients and nearly half of their caregivers reported clinically relevant anxiety, which is a higher rate than expected based on literature [11]. The context and source of anxiety, as described by patients and caregivers, commonly centers around the unpredictable nature of subsequent NMOSD attacks, the progressive nature of the disease, and a lack of information about what to expect at the time of diagnosis.…”

Section: Discussionmentioning

confidence: 91%

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The psychological burden of NMOSD – a mixed method study of patients and caregivers

Esiason,

Ciesinski,

Nurse

et al. 2024

PLoS ONE

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Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disorder of the central nervous system with common symptoms of rapid onset of eye pain, loss of vision, neck/back pain, paralysis, bowel and bladder dysfunction and heat sensitivity. The rare, unpredictable, and debilitating nature of NMOSD constitutes a unique psychological burden for patients and their caregivers, the specific nature and extent of which is not yet known. This mixed methods study, informed by both quantitative and qualitative data collected via self-report measures, focus groups, and in-depth interviews, aims to investigate and understand the psychological burden of patients with NMOSD and their caregiver/loved ones, so as to inform a specialized intervention. 31 adults living with NMOSD and 22 caregivers of people with NMOSD in the United States and Canada, recruited from NMOSD patient advocacy groups, social media groups, and through word of mouth from other participants, completed a battery of standardized self-report measures of anxiety, depression, trauma, cognitive fusion, valued living, and coping styles. Semi-structured focus group sessions were conducted via HIPAA-compliant Zoom with 31 patients, and separate focus groups were conducted with 22 caregivers. A subset of these samples, comprised of 16 patients and 11 caregivers, participated in individual semi-structured interviews, prioritizing inclusion of diverse perspectives. Descriptive statistics and bivariate correlations were run on quantitative self-report data using SPSS [Version 28.0.1]; data were stored in REDCap. Reflexive thematic analysis was employed regarding qualitative individual interview data. The majority of patients reported experiencing anxiety, depression, cognitive fusion, over-controlled coping, and lack of values-based living. Caregivers also reported heightened anxiety, cognitive fusion, and over-controlled coping, although they did not endorse clinically significant depression. Patient and caregiver degree of anxiety and of overcontrolled coping were both strongly positively correlated, likely affecting how both parties manage NMOSD-related stressors, both individually and as a dyad. Patients reported more anxiety, depression, psychological inflexibility, and lack of values-based living, compared with caregivers. Patient and caregiver narrative themes included mistrust of medical professionals, lack of support immediately following diagnosis, changes in relationships, deviation from values-based living, internalization of feelings, and avoidant coping strategies to manage the psychological burden of NMOSD. A novel mental health intervention targeting the specific psychological burden of life with NMOSD is proposed.

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Section: Discussionmentioning

confidence: 91%

“…Depression and anxiety are common among individuals with NMOSD, with 30% to 50% endorsing clinically significant depressive symptoms [7][8][9][10] and 33% endorsing anxiety [11]. NMOSD patients are twice as likely to experience Major Depressive Disorder and high suicidal risk, as compared with patients with Multiple Sclerosis [9].…”

Section: Introductionmentioning

confidence: 99%

The psychological burden of NMOSD – a mixed method study of patients and caregivers

Esiason,

Ciesinski,

Nurse

et al. 2024

PLoS ONE

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“…Depression is significantly greater in NMO patients than in healthy subjects and MS controls 64–67 ; anxiety also is reported to influence the quality of life in NMO. 68 , 69 The multifactorial aetiology of these behavioural manifestations complicates assigning cause. Chronic disease itself associates with psychological disorders.…”

Section: Discussionmentioning

confidence: 99%

Spectrum of sublytic astrocytopathy in neuromyelitis optica

Guo

Lennon

Parisi

et al. 2021

Brain

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Neuromyelitis optica is an autoimmune inflammatory disorder targeting aquaporin-4 water channels in CNS astrocytes. Histopathologic descriptions of astrocytic lesions reported in neuromyelitis optica to date have emphasized a characteristic loss of aquaporin-4, with deposition of IgG and complement and lysis of astrocytes, but sublytic reactions have been underappreciated. We performed a multi-modality study of 23 neuromyelitis optica autopsy cases (clinically and/or pathologically-confirmed; 337 tissue blocks). By evaluating astrocytic morphology, immunohistochemistry and AQP4 RNA transcripts, and their associations with demyelinating activity, we documented a spectrum of astrocytopathy in addition to complement deposition, microglial reaction, granulocyte infiltration and regenerating activity. Within advanced demyelinating lesions, and in periplaque areas, there was remarkable hypertrophic astrogliosis, more subtle than astrocytic lysis. A degenerative component was suggested by “dystrophic” morphology, cytoplasmic vacuolation, Rosenthal fibres and associated stress protein markers. The abundance of AQP4 mRNA transcripts in sublytic reactive astrocytes devoid of aquaporin-4 protein supported in vivo restoration following IgG-induced aquaporin-4 endocytosis/degradation. Astrocytic alterations extending beyond demyelinating lesions speak to astrocytopathy being an early and primary event in the evolving neuromyelitis optica lesion. Focal astrocytopathy observed without aquaporin-4 loss or lytic complement component deposition verifies that astrocytic reactions in NMO are not solely dependent on IgG-mediated aquaporin-4 loss or lysis by complement or by IgG-dependent leukocyte mediators. We conclude that neuromyelitis optica reflects a global astrocytopathy, initiated by binding of IgG to aquaporin-4 and not simply definable by demyelination and astrocytic lysis. The spectrum of astrocytic morphological changes in neuromyelitis optica attests to the complexity of factors influencing the range of astrocytic physiological responses to a targeted attack by aquaporin-4-specific IgG. Sublytic astrocytic reactions are no doubt an important determinant of the lesion’s evolution and potential for repair. Pharmacological manipulation of the astrocytic stress response may offer new avenues for therapeutic intervention.

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“…In addition, in a few studies conducted on psychological disorders in patients with this disease, it has been shown that psychological problems are significantly prevalent in these patients. Ebadi et al in their study found that depression, anxiety, hostility, and somatization rates were significantly higher in NMOSD patients compared to the control group [43]. Other studies have reported high rates of depression in these patients [44,45].…”

Section: Psychological Aspects Of Nmosd During the Covid-19 Pandemicmentioning

confidence: 93%

Psychological Aspects of Neuroinflammatory Disorders in COVID-19 Era

Moghadasi¹

2021

Anxiety, Uncertainty, and Resilience During the Pandemic Period - Anthropological and Psychological Perspectives

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Although the COVID-19 pandemic was initially manifested as a contagious respiratory infection, its other aspects quickly became apparent. Accordingly, the disease could affect various organs such as skin, digestive system, and the central nervous system. Apart from these diverse manifestations, it was rapidly cleared that the virus could potentially play a role in causing a wide range of autoimmune diseases. Moreover, various anthropological aspects of COVID-19 and its effects on human life were considered. In this regard, one of the important issues is its psychological effects, not only on the population of healthy people, but also on people suffering from underlying diseases. Inflammatory diseases of the central nervous system are included as one group of these diseases. Since these diseases can cause many psychological problems in patients, it is very important to pay attention to them during the COVID-19 pandemic. In the following section, the psychological aspects of COVID-19 in patients with neuroinflammatory diseases are described.

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Evaluation of types of psychological disorders in patients with neuromyelitis optica spectrum disorder (NMOSD)

Cited by 8 publications

References 16 publications

The psychological burden of NMOSD – a mixed method study of patients and caregivers

The psychological burden of NMOSD – a mixed method study of patients and caregivers

Spectrum of sublytic astrocytopathy in neuromyelitis optica

Psychological Aspects of Neuroinflammatory Disorders in COVID-19 Era

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