Neuromyelitis optica: effect of gender

J Neurol Sci. 2009 Nov 15;286(1-2):18-23. doi: 10.1016/j.jns.2009.08.045. Epub 2009 Sep 8.


Neuromyelitis optica is a distinct CNS demyelinating disease associated with the autoantibody NMO-IgG, which targets the water channel aquaporin-4. Neuromyelitis optica may be distinguished from typical multiple sclerosis on the basis of key clinical and neuroimaging characteristics in addition to detection of NMO-IgG. The disease has an even stronger female predilection than does multiple sclerosis, with a reasonably consistent female to male gender ratio of >3:1 reported from samples of diverse racial and regional populations worldwide. The gender distribution appears to be similar in both childhood-onset and adult-onset cases. Female gender is associated with a relapsing course and familial disease, but the influence of gender on disease severity and treatment response are not clear. Population-based epidemiological and genetic studies, with case ascertainment aided by the high specificity of NMO-IgG and consistent disease definitions, are needed to better define and understand gender effects in neuromyelitis optica.

MeSH terms

  • Adult
  • Age of Onset
  • Aquaporin 4 / immunology
  • Autoantibodies / therapeutic use
  • Female
  • Humans
  • Male
  • Neuromyelitis Optica / diagnosis
  • Neuromyelitis Optica / epidemiology*
  • Neuromyelitis Optica / genetics
  • Neuromyelitis Optica / therapy
  • Sex Factors
  • Sex Ratio


  • Aquaporin 4
  • Autoantibodies