Department of Neurology, Ibn Sina Hospital, Kuwait.
Department of Neurology, Ibn Sina Hospital, Kuwait; Department of Neurology and Psychiatry, Minia University, Egypt.
Clin Neurol Neurosurg. 2020 Sep;196:106047. doi: 10.1016/j.clineuro.2020.106047. Epub 2020 Jun 24.
Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory demyelinating disorder of the central nervous system that predominantly targets optic nerves and spinal cord. Studies of NMOSD are scarce in the Middle East.
To evaluate the MRI characteristics of NMOSD patients in Kuwait.
This is an observational, retrospective study on NMOSD patients who attended the MS clinic. Patients who fulfilled the 2015 diagnostic criteria of NMOSD were included. Patients` clinical, radiological and serological data were extracted from the medical records. The radiological variables were compared according to gender and AQP4 serostatus.
Forty-two patients fulfilling the NMOSD diagnostic criteria. The mean age and mean age of onset were 32.6 ± 11.4 and 28.9 ± 9.8 years respectively. Females represented 83.3 % of the cohort with female-to-male ratio of 5:1. Thirty-one patients (73.8 %) tested positive for AQP4 antibody. Nineteen patients (45.2 %) had bilateral optic nerve involvement, while chiasmal involvement was seen in 8 (19.0 %) patients. Spinal cord was involved in 36 (85.7 %) patients; of whom 27 (64.3 %) had LETM. The most common spinal segment involved was the cervical (72.2 %) followed by the dorsal (25.0 %) regions. The brain was involved in 39 (92.8 %) patients and the periventricular region around fourth and lateral ventricles was the most commonly involved site (n = 35; 83.3 %), along with periaqueductal (n = 25; 61.9 %) and corpus callosal (n = 24; 57.1 %) regions. Isolated area postrema involvement was observed in 9 (21.4 %) patients.
This is the first study describing the radiological characteristics of NMOSD in Kuwait. Although our data is comparable with the previous international studies, a higher percentage of bilateral optic nerve, brain, and callosal involvement was observed. Further multicenter studies with a larger cohort are needed to confirm our results.
视神经脊髓炎谱系疾病（NMOSD）是一种中枢神经系统的炎症性脱髓鞘疾病，主要影响视神经和脊髓。中东地区对 NMOSD 的研究较少。
评估科威特 NMOSD 患者的 MRI 特征。
这是一项观察性、回顾性研究，纳入了在 MS 诊所就诊的 NMOSD 患者。符合 2015 年 NMOSD 诊断标准的患者纳入研究。从病历中提取患者的临床、放射学和血清学数据。根据性别和 AQP4 血清学状态比较放射学变量。
符合 NMOSD 诊断标准的 42 例患者。平均年龄和发病年龄分别为 32.6±11.4 岁和 28.9±9.8 岁。女性占队列的 83.3%，女性与男性的比例为 5:1。31 例（73.8%）患者 AQP4 抗体检测阳性。19 例（45.2%）患者双侧视神经受累，8 例（19.0%）患者视交叉受累。36 例（85.7%）患者脊髓受累；其中 27 例（64.3%）为长节段横贯性脊髓炎。最常受累的脊髓节段是颈段（72.2%），其次是背段（25.0%）。39 例（92.8%）患者脑受累，最常受累的部位是第四脑室和外侧脑室周围区域（n=35；83.3%），其次是导水管周围（n=25；61.9%）和胼胝体（n=24；57.1%）区域。9 例（21.4%）患者孤立性后联合受累。
这是首例描述科威特 NMOSD 放射学特征的研究。虽然我们的数据与以往的国际研究相似，但双侧视神经、脑和胼胝体受累的比例较高。需要进一步开展多中心、更大队列的研究来证实我们的结果。
