Neuromyelitis optica spectrum disorder and multiple sclerosis: Differentiation by a multimodal approach

Deep gray matter atrophy in neuromyelitis optica spectrum disorder and multiple sclerosis

“…The data presented here appear broadly consistent with the majority of studies evaluating Asian populations, which reported significant thalamic atrophy in patients with NMOSD compared with HCs . However, two previous studies evaluating Caucasian patients reported no significant differences in the thalamic volumes between patients with NMOSD and HCs .…”

“…As the thalamus is located near the ventricle where AQP4‐IgG is highly expressed, it is more likely to be involved in NMOSD . Additionally, in spite of the more severe disability and a longer time interval from disease onset to treatment in NMOSD compared with MS groups, DGM atrophy in patients with NMOSD demonstrated more regional and a lower volume reduction compared with that in patients with MS, which is consistent with previous studies . Not only imaging studies, but also previous pathological studies in MS indicate global damage of the DGM including the thalamus, hypothalamus, caudate, pallidum and putamen .…”

“…Although many earlier studies failed to find gray matter abnormalities in NMOSD [7][8][9][10], a number of recent studies have begun to reveal gray matter pathology in these patients [11][12][13][14][15][16][17]. Recent studies described no correlation between cortical gray matter thinning and clinical disability including CI in NMOSD [11,12].…”

“…Recent studies described no correlation between cortical gray matter thinning and clinical disability including CI in NMOSD [11,12]. However, the presence of subcortical deep gray matter (DGM) atrophy and its clinical implications in NMOSD were controversial in previous studies, due to small sample sizes and different evaluation tools [9,10,[14][15][16][17]. Additionally, some of these previous studies failed to include patients with multiple sclerosis (MS) in their analyses, an important comparison arm that is necessary for the differentiation of NMOSD [10,15,16].…”

Normal brain imaging accompanies neuroimmunologically justified, autoimmune encephalomyelitis

“…Diffusion tensor images (DTIs) were acquired using the parameters previously described. 7 , 8 We performed DTI in the axial plane (repetition time [TR]/echo time [TE], 5,760/62 or 8,300/73 ms; matrix, 80 × 80 or 76 × 76; field of view (FOV), 240 × 240 mm; 60 or 55 continuous transverse slices; slice thickness, 3 mm with no inter slice gap). To enhance the signal-to-noise ratio, acquisition was performed twice.…”