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Early Treatment Initiation With Oral Prednisolone for Relapse Prevention Alleviates Depression and Fatigue in Aquaporin-4–Positive Neuromyelitis optica Spectrum Disorder
- Source :
- Frontiers in Neurology, Vol 12 (2021)
- Publication Year :
- 2021
- Publisher :
- Frontiers Media SA, 2021.
-
Abstract
- Background:Neuromyelitis optica spectrum disorder (NMOSD) is a relapsing autoimmune-related neurological disorder of the central nervous system. Most patients with NMOSD have serum anti-aquaporin-4 immunoglobulin G antibodies (AQP4-IgG). In addition to optic neuritis and myelitis, other insidious symptoms such as depressive state and chronic fatigue in NMOSD are gradually being recognized.Methods: To elucidate the impact of low- to medium-dose oral prednisolone (PSL) as a relapse prevention therapy for psychiatric disturbances and chronic fatigue in NMOSD, we evaluated clinical data from 39 patients with AQP4-IgG-positive NMOSD, along with the details of present and cumulative oral PSL dosage.Results: Thirty-six of the 39 patients were treated with low- to medium-dose oral PSL, and the mean and standard deviation of the present daily dose of oral PSL were 7.9 ± 4.0 mg/day. None of the patients were treated with a daily PSL dose of >15 mg. As a result, the disease duration and the untreated period before starting oral PSL showed weak to moderate correlations with the subsequent severities of psychiatric disturbance and fatigue level. Meanwhile, none of the other treatment-related variables evaluated, such as the present oral PSL daily dose, cumulative PSL dose, months of oral PSL administration, previous courses of steroid pulse therapy, and coadministered immunosuppressants, were correlated with these insidious symptoms.Conclusion: Our results suggest that the use of long-term low- to medium-dose oral PSL ≤15 mg daily for relapse prevention in AQP4-IgG-positive NMOSD would not aggravate the psychiatric and fatigue conditions. On the contrary, early initiation of oral PSL for relapse prevention, together with significantly decreased relapse rate, alleviated the subsequent depressive state and fatigue from the disease.
- Subjects :
- medicine.medical_specialty
Myelitis
Neurological disorder
Relapse prevention
PSL
Gastroenterology
lcsh:RC346-429
03 medical and health sciences
0302 clinical medicine
Internal medicine
Medicine
Optic neuritis
030212 general & internal medicine
lcsh:Neurology. Diseases of the nervous system
Depression (differential diagnoses)
Neuromyelitis optica
business.industry
Chronic fatigue
medicine.disease
Neurology
psychiatric disturbances
anti-aquaporin-4 antibodies
depression
fatigue
oral prednisolone
Neurology (clinical)
neuromyelitis optica spectrum disorders
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 16642295
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- Frontiers in Neurology
- Accession number :
- edsair.doi.dedup.....15d56f2e547e6a829b1cbd97889dcb2d
- Full Text :
- https://doi.org/10.3389/fneur.2021.608149