Brain abnormalities in neuromyelitis optica

Kim, Jee Eun; Kim, Sung Min; Ahn, Sanghoon; Lim, Byung Chan; Chae, Jong Hee; Hong, Yoon Ho; Park, Kyung Seok; Sung, Jung Joon; Lee, Kwang Woo

doi:10.1016/j.jns.2010.12.001

Cited by 55 publications

(57 citation statements)

References 41 publications

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“…20,21 Also consistent with previous case studies is our observation that the most common location for an NMOSD lesion is deep white matter. 19,22,23 We also show that medullary lesions are more common in NMOSD than RRMS. These lesions may be contiguous with a high cervical spinal cord lesion.…”

supporting

confidence: 58%

Distinction of seropositive NMO spectrum disorder and MS brain lesion distribution

et al. 2013

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Objective: Neuromyelitis optica and its spectrum disorder (NMOSD) can present similarly to relapsingremitting multiple sclerosis (RRMS). Using a quantitative lesion mapping approach, this research aimed to identify differences in MRI brain lesion distribution between aquaporin-4 antibody-positive NMOSD and RRMS, and to test their diagnostic potential.Methods: Clinical brain MRI sequences for 44 patients with aquaporin-4 antibody-positive NMOSD and 50 patients with RRMS were examined for the distribution and morphology of brain lesions. T2 lesion maps were created for each subject allowing the quantitative comparison of the 2 conditions with lesion probability and voxel-wise analysis.Results: Sixty-three percent of patients with NMOSD had brain lesions and of these 27% were diagnostic of multiple sclerosis. Patients with RRMS were significantly more likely to have lesions adjacent to the body of the lateral ventricle than patients with NMOSD. Direct comparison of the probability distributions and the morphologic attributes of the lesions in each group identified criteria of "at least 1 lesion adjacent to the body of the lateral ventricle and in the inferior temporal lobe; or the presence of a subcortical U-fiber lesion; or a Dawson's finger-type lesion," which could distinguish patients with multiple sclerosis from those with NMOSD with 92% sensitivity, 96% specificity, 98% positive predictive value, and 86% negative predictive value. Neuromyelitis optica (NMO) is an inflammatory demyelinating condition of the CNS with a predilection for the optic nerves and spinal cord. NMO spectrum disorder (NMOSD) is a term used to encompass NMO (with both optic neuritis and myelitis) 1 and limited phenotypes such as recurrent optic neuritis or myelitis. It is an autoimmune disorder, mediated in most cases by antibodies to the aquaporin-4 (AQP4) water channel, 2,3 and for the majority of patients serum AQP4 antibodies (AQP4-abs) can be detected with an immunoassay. 4 Making a definitive diagnosis of antibodynegative NMOSD can be challenging because the more prevalent relapsing-remitting multiple sclerosis (RRMS) can present similarly (e.g., with attacks of optic neuritis and myelitis). 1,5,6 It is vitally important to distinguish these 2 conditions: patients with NMOSD require long-term immunosuppression to prevent devastating relapses, and disease-modifying treatments for RRMS such as b-interferon can worsen NMOSD. Conclusion:7,8 Hence, we need other markers to help promptly identify those who should be antibody tested, and to diagnose seronegative disease.MRI is the best noninvasive tool we have for visualizing the pathology of neuroinflammatory diseases in vivo, and has proven particularly useful in identifying patients with longitudinally extensive transverse myelitis (LETM), which is highly suggestive of NMOSD.

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confidence: 58%

Distinction of seropositive NMO spectrum disorder and MS brain lesion distribution

et al. 2013

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“…The incidence of brain MRI abnormalities in the patients with NMO was 75.2% (103/137) in our study, which is consist ent with other reports on Asian populations [3,16,17]. In the first analysis summarized in Table 1, we have found that the relapse number, EDSS score at initial diagnosis, and EDSS score at last visit were significantly higher in NMO patients with brain abnormalities than those in NMO patients without brain abnormalities.…”

Section: Discussionsupporting

confidence: 90%

Clinical Outcomes of Neuromyelitis Optica with Brain Magnetic Resonance Imaging Abnormalities

Huang¹,

Zhang²,

Lin³

et al. 2015

J Neurol Neurol Sci Disord

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Objective: To investigate clinical outcomes of neuromyelitis optica (NMO) patients with brain magnetic resonance imaging (MRI) abnormalities. Methods:One hundred and thirty-seven patients with NMO were enrolled. Clinical, laboratory, and MRI features were assessed and compared according to different distribution patterns of brain lesions. Results:The relapse number, Expanded Disability Status Scale (EDSS) score at initial diagnosis, and EDSS score at last visit were significantly higher in NMO patients with brain abnormalities than those in NMO patients without brain abnormalities, respectively. NMO patients with brainstem involvement had higher relapse number, EDSS score at initial diagnosis, and EDSS score at last visit than those without brain abnormalities or with only suprotentorial lesions. Conclusions:Appearance of brain abnormalities in the initial stage, especially brainstem involvement, might be a predictor of severe neurologic deficits and poor prognosis in NMO.

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“…In MS, lesions are small, non-edematous, and the intensity is homogenous in the acute phase and they are more commonly located at lower margin of CC. [56][57][58][59] As Chen et al [6] showed in their study, subcallosal dash dot sign was helpful as it was more common in patient with MS than in the NMO. In another study by Makino et al, [36] it was showed that involvement of splenium of CC in NMO patients was more common than the involvement of the same area in patients with MS (57% vs. 27%).…”

Section: In Devic's Neuromyelitis Optica Mrimentioning

confidence: 78%

Neuroimaging of corpus callosum in central nervous system demyelinating disorders

Etemadifar¹,

Neshatfar²,

Zamani³

et al. 2017

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Corpus callosum (CC) is the largest white matter structure in the brain, consisting of 200-250 million contralateral axonal projections. It is the major commissural pathway connecting the hemispheres of human brain. The pathology of CC includes wide variety of entities that arise from different causes such as congenital, inflammatory, tumoral, degenerative, infectious, etc. This study reviews the most reliable neuroimaging data of human CC in central nervous system (CNS) demyelinating diseases to facilitate the understanding of different pathological entities of the CC and their role in anticipation of probable prognostic findings. After a brief description of normal anatomy and functions of CC, this review examines the most valuable findings obtained using conventional and functional magnetic resonance imaging. It also demonstrates the most well organized findings of how CC features influence prognostic factors of demyelinating disorders, which could have a great value for choosing proper therapy methods. The authors also provided a brief review of other demyelinating disorders which are primarily caused by other pathological factors other than autoimmunity. As a conclusion, the authors showed the importance of CC as an critical part of the brain, which should be explored by different methods of imaging, correspondent to clinical evaluation of CNS demyelinating disorder to widen our knowledge on pathology and clinical patterns of such disorders. Key words:Corpus callosum, central nervous system, demyelinating diseases, neuroimaging, review ABSTRACTArticle history:

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Brain abnormalities in neuromyelitis optica

Cited by 55 publications

References 41 publications

Distinction of seropositive NMO spectrum disorder and MS brain lesion distribution

Distinction of seropositive NMO spectrum disorder and MS brain lesion distribution

Clinical Outcomes of Neuromyelitis Optica with Brain Magnetic Resonance Imaging Abnormalities

Neuroimaging of corpus callosum in central nervous system demyelinating disorders

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