Guanmei Cao1, Yunyun Duan1, Ningnannan Zhang2, Jie Sun2, Haiqing Li3, Yuxin Li3, Yongmei Li4, Chun Zeng4, Xuemei Han5, Fuqing Zhou6, Muhua Huang6, Zhizheng Zhuo1, Sven Haller7, Yaou Liu8. 1. Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. 2. Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China. 3. Radiology department, Huashan Hospital, Fudan University, Shanghai, China. 4. Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China. 5. No.1 Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, 130031, China. 6. Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, 330006, China. 7. Department of Imaging and Medical Informatics, University of Geneva, Faculty of Medicine of the University of Geneva, Geneva, Switzerland. 8. Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. Electronic address: asiaeurope80@gmail.com.
Abstract
PURPOSE: To investigate the brain MRI features in neuromyelitis optica spectrum disorders (NMOSD) and its clinical relevance in a large multi-center cohort in China. METHODS: 270 NMOSD patients were recruited from seven centers. The brain MRI were classified as normal, NMOSD-specific lesions, multiple sclerosis-like, nonspecific white matter changes. Brain volumes including whole brain, white, gray matter, cortex and subcortex gray matter volume were measured. The relationship between MRI measures, clinical disability and cognitive impairment were investigated. RESULTS: 98 patients (36.3%) had normal brain MRI; 48 patients (17.7%) had NMOSD-specific lesions located in dorsal brainstem, corticospinal tract corpus, callosum and periependymal lesions surrounding the ventricular system; 16 patients (6%) had multiple sclerosis-like lesions; and 108 patients (40%) had nonspecific white matter changes. NMOSD patients with brain lesions had a trend of lower subcortex gray matter volume compared to patients without lesions. 52.5% patients with normal brain MRI and 50.8% patients with abnormal brain MRI showed cognitive impairment. No significant differences were identified in brain volume between cognitive impairment and cognitive preserved groups. CONCLUSION: In this large multicenter NMOSD cohort, nonspecific white matter changes were the most common findings (40%). NMOSD patients with brain lesions demonstrated a trend of having lower brain volume than patients without lesions. Approximately 50% NMOSD patients presented cognitive impairment independent of brain lesions.
PURPOSE: To investigate the brain MRI features in neuromyelitis optica spectrum disorders (NMOSD) and its clinical relevance in a large multi-center cohort in China. METHODS: 270 NMOSD patients were recruited from seven centers. The brain MRI were classified as normal, NMOSD-specific lesions, multiple sclerosis-like, nonspecific white matter changes. Brain volumes including whole brain, white, gray matter, cortex and subcortex gray matter volume were measured. The relationship between MRI measures, clinical disability and cognitive impairment were investigated. RESULTS: 98 patients (36.3%) had normal brain MRI; 48 patients (17.7%) had NMOSD-specific lesions located in dorsal brainstem, corticospinal tract corpus, callosum and periependymal lesions surrounding the ventricular system; 16 patients (6%) had multiple sclerosis-like lesions; and 108 patients (40%) had nonspecific white matter changes. NMOSD patients with brain lesions had a trend of lower subcortex gray matter volume compared to patients without lesions. 52.5% patients with normal brain MRI and 50.8% patients with abnormal brain MRI showed cognitive impairment. No significant differences were identified in brain volume between cognitive impairment and cognitive preserved groups. CONCLUSION: In this large multicenter NMOSD cohort, nonspecific white matter changes were the most common findings (40%). NMOSD patients with brain lesions demonstrated a trend of having lower brain volume than patients without lesions. Approximately 50% NMOSD patients presented cognitive impairment independent of brain lesions.
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