Servicio de Neurología, Hospital Italiano de Buenos Aires, Argentina, Gascón 450, Buenos Aires C 1181 Argentina.
Servicio de Neurología, Hospital Italiano de Buenos Aires, Argentina, Gascón 450, Buenos Aires C 1181 Argentina.
Mult Scler Relat Disord. 2020 Jul;42:102049. doi: 10.1016/j.msard.2020.102049. Epub 2020 Mar 14.
There is scarce evidence comparing the behavior in magnetic resonance (MRI) between positive and negative aquaporin-4 antibody neuromyelitis optica spectrum disorders (P-NMOSD and NNMOSD, respectively). The aim of this study was to describe and compare MRI features through a quantitative and qualitative analysis between P-NMOSD and NNMOSD patients in a cohort from Latin American (LATAM) patients.
We retrospectively reviewed the MRI and medical records of NMOSD patients as defined by the 2015 validated diagnostic criteria, and with at least 3 years of follow-up from disease onset (first symptom). We included patients from Argentina, Brazil and Venezuela. To be included, NMOSD patients must have had AQP4-ab status measured by a cell-based assay. Brain MRIs were obtained for each participant at disease onset and every 12 months for 3 years. Demographics, clinical and MRI variables (T2 lesion volume [T2LV], lesion distribution, cortical thickness [CT] and percentage of brain volume loss [PBVL]) were analyzed and compared between groups (P-NMOSD; NNMOSD) at disease onset and follow-up. A multiple sclerosis (MS) control group of patients was also included.
We included 24 P-NMOSD, 15 NNMOSD and 35 MS patients. No differences in age, gender and follow-up time were observed between groups. Nor were differences found in lesion distribution at disease onset or in brain volumes during follow-up between P-NMOSD and NNMOSD patients (T2LV = 0.43, CT = 0.12, PBVL p = 0.45). Significant differences were observed in lesion distribution at disease onset, as well as in brain volumes during follow-up between NMOSD and MS (T2LV = p<0.001, CT = p<0.001, PBVL p = 0.01).
Different MRI features were observed between MS and NMOSD. However, no quantitative nor qualitative differences were observed between P-NMOSD and NNMOSD, not allowing us to differentiate NMOSD conditions by MRI.
在正性和负性水通道蛋白 4 抗体视神经脊髓炎谱系疾病（P-NMOSD 和 NNMOSD）患者的磁共振成像（MRI）行为方面，相关证据较为匮乏。本研究的目的是通过对拉丁美洲（LATAM）患者队列的定量和定性分析，对 P-NMOSD 和 NNMOSD 患者的 MRI 特征进行描述和比较。
我们对符合 2015 年验证性诊断标准的 NMOSD 患者的 MRI 和病历进行了回顾性分析，这些患者的疾病发作（首发症状）后至少随访 3 年。我们纳入了来自阿根廷、巴西和委内瑞拉的患者。为了纳入研究，NMOSD 患者必须通过基于细胞的检测方法测量 AQP4-ab 状态。每位参与者在疾病发作时以及 3 年内每 12 个月进行一次脑 MRI。我们对组间（P-NMOSD；NNMOSD）在疾病发作和随访时的人口统计学、临床和 MRI 变量（T2 病变体积[T2LV]、病变分布、皮质厚度[CT]和脑容量损失百分比[PBVL]）进行了分析和比较。我们还纳入了多发性硬化症（MS）对照组患者。
我们纳入了 24 例 P-NMOSD、15 例 NNMOSD 和 35 例 MS 患者。各组间在年龄、性别和随访时间方面无差异。在疾病发作时的病变分布或在随访期间的脑容量方面，P-NMOSD 和 NNMOSD 患者之间也未发现差异（T2LV=0.43，CT=0.12，PBVL p=0.45）。在疾病发作时的病变分布以及在随访期间的脑容量方面，NMOSD 和 MS 之间存在显著差异（T2LV=P<0.001，CT=P<0.001，PBVL p=0.01）。
在 MS 和 NMOSD 之间观察到不同的 MRI 特征。然而，在 P-NMOSD 和 NNMOSD 之间没有观察到定量或定性差异，因此我们无法通过 MRI 来区分 NMOSD 情况。
