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Front. Neurol., 21 August 2020 |

Pain in NMOSD and MOGAD: A Systematic Literature Review of Pathophysiology, Symptoms and Current Treatment Strategies

  • 1NeuroCure, Charité Medical University of Berlin, Germany
  • 2Experimental and Clinical Research Center, Charite University Medicine Berlin, Germany
  • 3Experimental and Clinical Research Center, Charité – Universitätsmedizin Berlin, Germany
  • 4Department of Neurology, Charité Medical University of Berlin, Germany

Neuromyelitis optica spectrum disorders (NMOSD) and Myelin Oligodendrocyte Glycoprotein-antibody-Associated Disease (MOGAD) are autoimmune inflammatory disorders of the central nervous system (CNS). Pain is highly prevalent and debilitating in NMOSD and MOGAD with a severe impact on quality of life and there is a critical need for further studies to successfully treat and manage pain in these rare disorders. In NMOSD, pain has a prevalence of over 80% and pain syndromes include neuropathic, nociceptive, and mixed pain, which can emerge in acute relapse or become chronic during the disease course. The impact of pain in MOGAD has only recently received increased attention, with a prevalence of 50%. These patients typically experience severe headache, retrobulbar pain and/or pain on eye movement in optic neuritis but also neuropathic and nociceptive pain. Given the high relevance of pain in MOGAD and NMOSD, this article provides a systematic review the current literature pertaining to pain in both disorders, focusing on the etiology of their respective pain syndromes and their pathophysiological background. Acknowledging the challenge and complexity of diagnosing pain, we also provide a mechanism-based classification of NMOSD- and MOGAD-related pain syndromes and summarize current treatment strategies.

Keywords: Aquaporin 4, Headache, Myelin Oligodendrocyte Glycoprotein-antibody Associated Disease, neuromyelitis optica spectrum disorders, neuropathic pain, Pain, Painful tonic spasms

Citation: Asseyer S, Cooper G and Paul F (2020). Pain in NMOSD and MOGAD: A Systematic Literature Review of Pathophysiology, Symptoms and Current Treatment Strategies. Front. Neurol. 11:778. doi: 10.3389/fneur.2020.00778

Received: 13 Jan 2020; Accepted: 24 Jun 2020;
Published online: 21 Aug 2020.

Edited by:

Dalia L. Rotstein, University of Toronto, Canada

Reviewed by:

Natalie E. Parks, Dalhousie University, Canada
Courtney S. Casserly, Western University (Canada), Canada  

Copyright: © 2020 Asseyer, Cooper and Paul. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Friedemann Paul, NeuroCure, Charité Medical University of Berlin, Berlin, Germany,