Comparison of deep gray matter lesions on magnetic resonance imaging among adults with acute disseminated encephalomyelitis, multiple sclerosis, and neuromyelitis optica

Zhang, Lei; Wu, Ai-Min; Zhang, Bingjun; Chen, Su-Qin; Men, Xuejiao; Lin, Yinyao; Liu, Zhengqi

doi:10.1177/1352458513499420

Cited by 38 publications

(19 citation statements)

References 31 publications

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“…The conventional MRI protocols were described in our previous paper (Zhang et al., 2014). Gadopentate dimeglumine (Gd‐DTPA) was intravenously administered at a dose of 0.1 mmol/kg, and at about 15 min after contrast injection, the T1‐weighted sequence was repeated.…”

Section: Methodsmentioning

confidence: 99%

Elevated cerebrospinal fluid uric acid during relapse of neuromyelitis optica spectrum disorders

Shu

Zhang

et al. 2016

Brain and Behavior

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IntroductionPrevious studies have shown that serum uric acid (UA) modulates outcomes of neurological diseases, although little is known about cerebrospinal fluid (CSF) UA levels in neuromyelitis optica spectrum disorders (NMOSDs).MethodsCerebrospinal fluid and serum UA levels were measured in samples from 68 patients, including NMOSDs during relapse (n = 38) and controls with noninflammatory and non‐neurodegenerative diseases (CTLs, n = 30). Correlation analysis was performed between CSF UA and clinical characteristics, serum UA, and blood–brain barrier integrity in NMOSDs.ResultsCerebrospinal fluid UA levels in NMOSDs were significantly higher than in CTLs (p = .002), while serum UA differences between NMOSDs and CTLs were not statistically significant. In NMOSDs, CSF UA levels were significantly higher in patients with an impaired blood–brain barrier than in patients with an intact one (p < .001), and significantly higher in longer disease duration than in shorter disease duration patients (p = .002). CSF UA levels were also significantly higher in active patients upon MRI than in inactive patients (p < .001), and significantly higher in patients with brain lesions than without brain lesions (p = .024). CSF UA was significantly associated with the serum UA levels (r = .454, p = .002), disease duration (r = .383, p = .018), and blood–brain barrier index (r = .805, p < .001), but did not correlate with age, gender, annualized relapse rate, duration, or severity of NMOSD. Multiple regression analysis demonstrated that CSF UA was independent of the blood–brain barrier index (β = .765, p < .001) and serum UA levels (β = .01, p = .019) in NMOSDs.ConclusionsCerebrospinal fluid UA levels were elevated in NMOSD patients during relapse, and were likely modified by serum UA levels and blood–brain barrier integrity.

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Section: Methodsmentioning

confidence: 99%

Elevated cerebrospinal fluid uric acid during relapse of neuromyelitis optica spectrum disorders

Shu

Zhang

et al. 2016

Brain and Behavior

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“…82,83 Though ADEM is often monophasic, recent studies reported that relapses can occur in 10–18% of cases. 44,84,85 ADEM can manifest as LETM, bilateral multiple cerebral lesions of the white matter, 86 bilateral optic neuritis, 87 or deep gray matter lesions, 88 all of which can be seen in NMOSD. 1 Moreover, a considerable number of patients diagnosed with ADEM in clinical practice did not meet the current diagnostic criteria for ADEM, 84 highlighting the difficulties in defining ADEM.…”

Section: Differential Diagnosis Of Nmosdmentioning

confidence: 99%

Differential diagnosis of neuromyelitis optica spectrum disorders

Kim

Lee

et al. 2017

Ther Adv Neurol Disord

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Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disorder of the central nervous system (CNS) mostly manifesting as optic neuritis and/or myelitis, which are frequently recurrent/bilateral or longitudinally extensive, respectively. As the autoantibody to aquaporin-4 (AQP4-Ab) can mediate the pathogenesis of NMOSD, testing for the AQP4-Ab in serum of patients can play a crucial role in diagnosing NMOSD. Nevertheless, the differential diagnosis of NMOSD in clinical practice is often challenging despite the phenotypical and serological characteristics of the disease because: (1) diverse diseases with autoimmune, vascular, infectious, or neoplastic etiologies can mimic these phenotypes of NMOSD; (2) patients with NMOSD may only have limited clinical manifestations, especially in their early disease stages; (3) test results for AQP4-Ab can be affected by several factors such as assay methods, serologic status, disease stages, or types of treatment; (4) some patients with NMOSD do not have AQP4-Ab; and (5) test results for the AQP4-Ab may not be readily available for the acute management of patients. Despite some similarity in their phenotypes, these NMOSD and NMOSD-mimics are distinct from each other in their pathogenesis, prognosis, and most importantly treatment. Understanding the detailed clinical, serological, radiological, and prognostic differences of these diseases will improve the proper management as well as diagnosis of patients.

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“…Brain MRI abnormalities have been reported in previous studies in patients with NMO [6][7][8][9][10][13][14][15]. However, few studies have focused on effects of brain MRI abnormalities on NMO.…”

Section: Discussionmentioning

confidence: 93%

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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Comparison of deep gray matter lesions on magnetic resonance imaging among adults with acute disseminated encephalomyelitis, multiple sclerosis, and neuromyelitis optica

Abstract: Morphological features of deep gray matter lesions vary among adult patients with ADEM, MS, and NMO, and may be helpful in distinguishing these diseases.

Cited by 38 publications

References 31 publications

Elevated cerebrospinal fluid uric acid during relapse of neuromyelitis optica spectrum disorders

Elevated cerebrospinal fluid uric acid during relapse of neuromyelitis optica spectrum disorders

Differential diagnosis of neuromyelitis optica spectrum disorders

Clinical Outcomes of Neuromyelitis Optica with Brain Magnetic Resonance Imaging Abnormalities

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