Diagnostic Center of Pecs, University of Pecs, Pecs, Hungary.
Eur Neurol. 2013;69(4):221-5. doi: 10.1159/000345799. Epub 2013 Jan 10.
The long-term effect of neuromyelitis optica (NMO) on the brain is not well established.
After 22 years of NMO, a patient's brain was examined by quantitative T1- and T2-weighted mono- and biexponential diffusion and proton spectroscopy. It was compared to 3 cases with short-term NMO and 20 healthy subjects.
Although routine T1- and T2-weighted images appeared to be normal, quantitative T1-, T2- and diffusion-weighted magnetic resonance imaging identified areas with high diffusivity and altered relaxation time in 'normal appearing white matter' (NAWM). In such abnormal NAWM regions, biexponential diffusion analysis and quantitative spectroscopy indicated extracellular edema and axonal loss, respectively. Repeated analysis 6 months later identified the same alterations. Such patchy alterations were not detectable in the NAWM of the 3 cases with short-term NMO, and they were also not quantitatively different from the controls.
After NMO of 22-year duration, metabolic changes, altered diffusivity and magnetic resonance relaxation features of patchy brain areas may suggest tissue damage in NAWM that persist for at least 6 months.
视神经脊髓炎（NMO）对大脑的长期影响尚未得到充分证实。
在 NMO 发病 22 年后，对患者的大脑进行了定量 T1-和 T2-加权单指数和双指数扩散及质子波谱检查，并与 3 例短期 NMO 患者和 20 名健康受试者进行了比较。
尽管常规 T1-和 T2-加权图像似乎正常，但定量 T1-、T2-和扩散加权磁共振成像在“正常外观的白质”（NAWM）中发现了高扩散性和弛豫时间改变的区域。在这些异常的 NAWM 区域，双指数扩散分析和定量波谱分别提示细胞外水肿和轴索丢失。6 个月后的重复分析确定了相同的改变。在 3 例短期 NMO 的 NAWM 中未检测到这种斑片状改变，并且与对照组也没有定量差异。
在 NMO 发病 22 年后，斑块状脑区的代谢变化、弥散性改变和磁共振弛豫特征可能提示 NAWM 中有持续至少 6 个月的组织损伤。
