The usefulness of brain MRI at onset in the differentiation of multiple sclerosis and seropositive neuromyelitis optica spectrum disorders

So Young Huh, Ju Hong Min, Woojun Kim, Su Hyun Kim, Ho Jin Kim, Byung Jo Kim, Byoung Joon Kim, Kwang Ho Lee

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)695-704
Number of pages10
JournalMultiple Sclerosis Journal
Volume20
Issue number6
DOIs
Publication statusPublished - 2014 Jan 1

Keywords

  • aquaporin-4
  • brain
  • MRI
  • multiple sclerosis
  • Neuromyelitis optica
  • onset

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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