Brain and nerve = Shinkei kenkyū no shinpo
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Neuromyelitis optica (NMO) is an inflammatory disease mainly affecting optic and spinal cords, and was originally described by Devic in 1894. There has been long controversy about whether NMO is a subtype of multiple sclerosis (MS) or a distinct disease. In Japan and other Asian countries, relapsing NMO has been called as optic-spinal form of MS (OSMS), but we reported in 2002 that OSMS was heterogeneous and it comprised both typical NMO and MS with optic spinal presentation. ⋯ Those results suggest that astrocytic damage associated with autoimmunity to AQP4 may be involved in the pathogenesis of NMO, which is distinct from MS, primarily demyelinating disease. After the long history of confusion, NMO became clearly discriminated disease from MS. In this review, we focus on the historical changes of the disease concept and new knowledge gained from the clinical or immunological analyses of NMO.