The role of cerebellar abnormalities in neuromyelitis optica--a comparison with multiple sclerosis and healthy controls

Mult Scler. 2015 May;21(6):757-66. doi: 10.1177/1352458514554051. Epub 2014 Dec 5.

Abstract

Background: In relapsing-remitting multiple sclerosis (RRMS), the cerebellum is a known predilection site for atrophy. Neuromyelitis optica (NMO) is characterized by extensive lesions in the spinal cord and optic nerve; however, cerebellar involvement has been less studied. Secondary degeneration of the spinocerebellar tract could impact the cerebellum in NMO.

Objective: We aimed to investigate whether spinal cord and cerebellar volume measures differ between patients with NMO and RRMS.

Methods: Volumetric analyses of the cerebellum (TCV), the upper cervical cord (UCV) as well as the whole brain (NBV) of age- and gender-matched patients with NMO (n=30; 56% AQP4 +ve) and RRMS (n=25) were performed on 3T brain magnetic resonance imaging (MRI) and compared with 34 healthy controls (HC).

Results: UCV was significantly reduced in NMO patients (6.3 cm(3)) as compared with HC (6.7 cm(3)), while patients with MS had reduced brain volumes compared with HC (NBV=1482 cm(3); p<0.001; TCV=188 cm(3); p=0.042), but UCV close to normal values. Patients with RRMS and NMO differed in NBV (p=0.001; lower in RRMS) and by trend (towards reduction in RRMS) in cerebellar volume (p=0.06).

Conclusions: While atrophy seems to be diffuse in MS patients, a rather focussed pattern with predominant involvement of the UCV was observed in NMO patients.

Keywords: Neuromyelitis optica; cerebellum; magnetic resonance imaging; multiple sclerosis; spinal cord; volumetry.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Atrophy / pathology
  • Brain / pathology*
  • Cerebellum / pathology*
  • Cervical Cord / pathology*
  • Female
  • Healthy Volunteers
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Multiple Sclerosis, Relapsing-Remitting / pathology*
  • Neuromyelitis Optica / pathology*
  • Young Adult