BACKGROUND: Although neuromyelitis optica (NMO) is a central nervous system (CNS) autoimmune disease distinct from multiple sclerosis (MS). NMO and NMO spectrum disorder (NMOSD) sometimes show asymptomatic lesions on brain magnetic resonance imaging (MRI) at onset, and even present with symptomatic brain involvement. OBJECTIVES: We investigated whether brain MRI at onset can be helpful for the differentiation of MS and NMOSD. METHODS: We retrospectively analyzed initial brain MRIs, performed within three months of onset, in patients with MS (n = 51) and anti-aquaporin4-antibody-positive patients with NMOSD (n = 67). RESULTS: NMOSD patients met the Paty (37%) and Barkhof (13%) criteria, and the criteria of the European Magnetic Imaging in MS (MAGNIMS) study group (9%), for MS. Ovoid lesions perpendicular to the lateral ventricle, isolated juxtacortical lesions in U-fibers and isolated ovoid/round cortical lesions were found only in MS patients, whereas longitudinal corticospinal tract lesions, extensive hemispheric lesions, periependymal lesions surrounding the lateral ventricle and cervicomedullary lesions were found only in NMOSD patients. CONCLUSIONS: Our study suggests that it is difficult to differentiate MS from NMOSD by the fulfillment of the MRI criteria for MS on brain MRI at onset; however, the characteristic morphology of brain lesions is highly useful for the early differentiation of the two disorders.
BACKGROUND: Although neuromyelitis optica (NMO) is a central nervous system (CNS) autoimmune disease distinct from multiple sclerosis (MS). NMO and NMO spectrum disorder (NMOSD) sometimes show asymptomatic lesions on brain magnetic resonance imaging (MRI) at onset, and even present with symptomatic brain involvement. OBJECTIVES: We investigated whether brain MRI at onset can be helpful for the differentiation of MS and NMOSD. METHODS: We retrospectively analyzed initial brain MRIs, performed within three months of onset, in patients with MS (n = 51) and anti-aquaporin4-antibody-positive patients with NMOSD (n = 67). RESULTS: NMOSD patients met the Paty (37%) and Barkhof (13%) criteria, and the criteria of the European Magnetic Imaging in MS (MAGNIMS) study group (9%), for MS. Ovoid lesions perpendicular to the lateral ventricle, isolated juxtacortical lesions in U-fibers and isolated ovoid/round cortical lesions were found only in MS patients, whereas longitudinal corticospinal tract lesions, extensive hemispheric lesions, periependymal lesions surrounding the lateral ventricle and cervicomedullary lesions were found only in NMOSD patients. CONCLUSIONS: Our study suggests that it is difficult to differentiate MS from NMOSD by the fulfillment of the MRI criteria for MS on brain MRI at onset; however, the characteristic morphology of brain lesions is highly useful for the early differentiation of the two disorders.
Authors: Àlex Rovira; Mike P Wattjes; Mar Tintoré; Carmen Tur; Tarek A Yousry; Maria P Sormani; Nicola De Stefano; Massimo Filippi; Cristina Auger; Maria A Rocca; Frederik Barkhof; Franz Fazekas; Ludwig Kappos; Chris Polman; David Miller; Xavier Montalban Journal: Nat Rev Neurol Date: 2015-07-07 Impact factor: 42.937
Authors: Maureen A Mealy; Anna Whetstone; Gunes Orman; Izlem Izbudak; Peter A Calabresi; Michael Levy Journal: J Neurol Sci Date: 2015-05-17 Impact factor: 3.181
Authors: Ho Jin Kim; Friedemann Paul; Marco A Lana-Peixoto; Silvia Tenembaum; Nasrin Asgari; Jacqueline Palace; Eric C Klawiter; Douglas K Sato; Jérôme de Seze; Jens Wuerfel; Brenda L Banwell; Pablo Villoslada; Albert Saiz; Kazuo Fujihara; Su-Hyun Kim Journal: Neurology Date: 2015-02-18 Impact factor: 9.910
Authors: Yeliz Pekcevik; Charles H Mitchell; Maureen A Mealy; Gunes Orman; In H Lee; Scott D Newsome; Carol B Thompson; Carlos A Pardo; Peter A Calabresi; Michael Levy; Izlem Izbudak Journal: Mult Scler Date: 2015-07-24 Impact factor: 6.312
Authors: Laura Clarke; Simon Arnett; Kate Lilley; Jacky Liao; Sandeep Bhuta; Simon A Broadley Journal: Clin Exp Immunol Date: 2021-07-06 Impact factor: 4.330