Brain magnetic resonance imaging findings in relapsing neuromyelitis optica

Cabrera-Gómez, José Antonio; Quevedo-Sotolongo, L; González‐Quevedo, Alina; Lima, Sandra Santana de; Real-González, Y; Cristofol-Corominas, M; Romero-García, K; Ugarte-Sánchez, C.; Jordán-González, J; Nuez, J E González de la; Lahera, J García; Tellez, R.; Pedroso-Ibáñez, Ivonne; Roca, R Rodríguez; Cabrera-Núñez, A Y

doi:10.1177/1352458506070725

Cited by 77 publications

(64 citation statements)

References 12 publications

(7 reference statements)

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“…These abnormalities in brain MRI findings, published in a previous paper [43], were: T2/FLAIR with the presence of subcortical or deep white matter lesions most < 3 mm without juxtacortical involvement; infratentorial lesions > 3 mm without cerebellar localization, periventricular lesions not morphologically oval, ovoid or perpendicularly oriented as in MS; on T1 images, hypointense regions or "black holes" and optic nerve enhancement were not observed. None of these cases fulfilled the diagnostic criteria of Barkhof et al [36] for MS and in no instance were they compatible with acute disseminated encephalomyelitis.…”

Section: Initial Events and Coursementioning

confidence: 80%

An epidemiological study of neuromyelitis optica in Cuba

Cabrera-Gómez¹,

et al. 2009

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Section: Initial Events and Coursementioning

confidence: 80%

An epidemiological study of neuromyelitis optica in Cuba

Cabrera-Gómez¹,

et al. 2009

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“…It is considered distinct from multiple sclerosis (MS) based on clinical, neuroimaging, pathological and immunological findings [1,5,9,11,12,14]. The serum autoantibody NMO-IgG, which binds selectively to aquaporin-4 (AQP4)…”

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confidence: 99%

Markedly increased CSF interleukin-6 levels in neuromyelitis optica, but not in multiple sclerosis

et al. 2009

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To investigate differences in helper T cell immune responses in cerebrospinal fluid (CSF) between neuromyelitis optica (NMO) and multiple sclerosis (MS), we measured CSF levels of interleukin (IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor-a and interferon-c at the time of relapse in 17 NMO patients and 21 MS patients using fluorescence-activated cell sorting. CSF IL-6 levels were significantly higher in NMO patients than in patients with MS (P = 0.001) and other neurological diseases (P = 0.001). The other cytokines tested were undetectable. Elevated CSF levels of IL-6 in only NMO supports the view of different pathophysiologies of NMO and MS. CSF IL-6 levels may be useful in the differential diagnosis of the two disorders.

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“…Nonspecific punctate or small (,3 mm) dots or patches of hyperintensities on T2-weighted or fluid-attenuated inversion recovery sequences in the subcortical or deep white matter have been described most frequently on brain imaging studies of NMOSD (35%-84%) 11,12,17 and are usually asymptomatic. Enhancing lesions.…”

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MRI characteristics of neuromyelitis optica spectrum disorder

et al. 2015

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Since its initial reports in the 19th century, neuromyelitis optica (NMO) had been thought to involve only the optic nerves and spinal cord. However, the discovery of highly specific antiaquaporin-4 antibody diagnostic biomarker for NMO enabled recognition of more diverse clinical spectrum of manifestations. Brain MRI abnormalities in patients seropositive for anti-aquaporin-4 antibody are common and some may be relatively unique by virtue of localization and configuration. Some seropositive patients present with brain involvement during their first attack and/or continue to relapse in the same location without optic nerve and spinal cord involvement. Thus, characteristics of brain abnormalities in such patients have become of increased interest. In this regard, MRI has an increasingly important role in the differential diagnosis of NMO and its spectrum disorder (NMOSD), particularly from multiple sclerosis. Differentiating these conditions is of prime importance because early initiation of effective immunosuppressive therapy is the key to preventing attack-related disability in NMOSD, whereas some disease-modifying drugs for multiple sclerosis may exacerbate the disease. Therefore, identifying the MRI features suggestive of NMOSD has diagnostic and prognostic implications. We herein review the brain, optic nerve, and spinal cord MRI findings of NMOSD. Neuromyelitis optica (NMO) is an inflammatory disease of the CNS that is characterized by severe attacks of optic neuritis (ON) and longitudinally extensive transverse myelitis (LETM). 1The past decade has witnessed dramatic advances in our understanding of NMO. Such advances were initiated by the discovery of the disease-specific autoantibody, NMO-immunoglobulin G (NMO-IgG), and subsequent identification of the main target autoantigen, aquaporin-4 (AQP4), which has distinguished NMO as a distinct disease from multiple sclerosis (MS). 2Current diagnostic criteria, however, still require both ON and myelitis for an NMO diagnosis.3 Nevertheless, the identification of anti-AQP4 antibodies beyond the current diagnostic criteria of NMO indicates a broader clinical phenotype of this disorder, so-called "NMO spectrum disorder" (NMOSD). 4,5 The NMOSD encompasses anti-AQP4 antibody seropositive patients with limited or inaugural forms of NMO and with specific brain abnormalities. It also includes anti-AQP4 antibody seropositive patients with other autoimmune disorders such as systemic

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Brain magnetic resonance imaging findings in relapsing neuromyelitis optica

Abstract: This study, based on a Cuban patient population, with long duration of disease, good sample size and detailed characterization by MRI, demonstrated the brain MRI pattern of R-NMO patients, which is different from MS.

Cited by 77 publications

References 12 publications

An epidemiological study of neuromyelitis optica in Cuba

An epidemiological study of neuromyelitis optica in Cuba

Markedly increased CSF interleukin-6 levels in neuromyelitis optica, but not in multiple sclerosis

MRI characteristics of neuromyelitis optica spectrum disorder

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