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

• Published in: Multiple sclerosis and related disorders Vol. 4; no. 6; pp. 515 - 520
• Main Authors: Ota, Miho, Sato, Noriko, Okamoto, Tomoko, Noda, Takamasa, Araki, Manabu, Yamamura, Takashi, Kunugi, Hiroshi
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.11.2015
• Subjects: Anisotropy; Aquaporin 4; Aquaporin 4 - immunology; Autoantibodies - metabolism; Brain - pathology; Diagnosis, Differential; Female; Gray Matter - pathology; Humans; Image Interpretation, Computer-Assisted; Magnetic Resonance Imaging; Male; Middle Aged; Multiple Sclerosis, Relapsing-Remitting - diagnosis; Multiple Sclerosis, Relapsing-Remitting - metabolism; Multiple Sclerosis, Relapsing-Remitting - pathology; Neurologic Examination; Neurology; Neuromyelitis Optica - diagnosis; Neuromyelitis Optica - metabolism; Neuromyelitis Optica - pathology; Neuromyelitis optica spectrum disorder; Organ Size; Relapsing-remitting multiple sclerosis; Severity of Illness Index; Tract-based spatial statistics; Voxel-based morphometry; RRMS; Aquaporin 4; diffusion tensor images; NMO immunoglobulin G; magnetic resonance imaging; Neuromyelitis optica spectrum disorder; MRI; CNS; AQP4; Expanded Disability Status Scale; family-wise error; IFN-β; tract-based spatial statistics; FDR; interferon-beta; NMO-IgG; false discovery rate; EDSS; VBM; MSSS; MS; multiple sclerosis; antibody binds aquaporin 4; TBSS; voxel-based morphometry; threshold-free cluster enhancement; NMOSD; neuromyelitis optica spectrum disorders; central nervous system; relapsing-remitting multiple sclerosis; TFCE; DTI; FEW; fractional anisotropy; FA; Multiple Sclerosis Severity Score; Tract-based spatial statistics; Voxel-based morphometry; Relapsing-remitting multiple sclerosis
• ISSN: 2211-0348; 2211-0356
• DOI: 10.1016/j.msard.2015.08.006

Abstract Background Neuromyelitis optica spectrum disorder (NMOSD) differs from multiple sclerosis (MS) by prognosis and approach to treatment, and it is thus important to distinguish NMOSD from MS. Objective We evaluated the structural brain abnormalities in patients with NMOSD and with relapsing-remitting MS (RRMS) using with MRI. Methods Twenty-one NMOSD patients with antibodies against aquaporin 4, 32 patients with RRMS, and current age- and sex- matched 39 healthy subjects underwent 3-T MRI. The differences in gray matter volume and fractional anisotropy (FA) value among the three groups were evaluated. Results There were significant global gray matter volume reductions of NMOSD and RRMS groups, compared to the healthy subjects. Significant and diffuse decreases in FA values were observed in both the NMOSD and RRMS patients. Significant gray matter volume and FA value reductions of the RRMS patients in the bilateral thalami and some regions were observed compared to the NMOSD patients. Conclusion Larger brain structural changes were seen in the RRMS group compared to the NMOSD group, and among them, the thalamus was revealed as the important region for the discrimination of these two diseases. MRI analyses of the brain may be helpful in differentiating NMOSD from RRMS patients.