Frequency of brain MRI abnormalities in neuromyelitis optica spectrum disorder at presentation: A cohort of Latin American patients

Mult Scler Relat Disord. 2018 Jan:19:73-78. doi: 10.1016/j.msard.2017.11.004. Epub 2017 Nov 8.

Abstract

Background: Brain magnetic resonance imaging (BMRI) lesions were classically not reported in neuromyelitis optica (NMO). However, BMRI lesions are not uncommon in NMO spectrum disorder (NMOSD) patients.

Objective: To report BMRI characteristic abnormalities (location and configuration) in NMOSD patients at presentation.

Methods: Medical records and BMRI characteristics of 79 patients with NMOSD (during the first documented attack) in Argentina, Brazil and Venezuela were reviewed retrospectively.

Results: BMRI abnormalities were observed in 81.02% of NMOSD patients at presentation. Forty-two patients (53.1%) showed typical-NMOSD abnormalities. We found BMRI abnormalities at presentation in the brainstem/cerebellum (n = 26; 32.9%), optic chiasm (n = 16; 20.2%), area postrema (n = 13; 16.4%), thalamus/hypothalamus (n = 11; 13.9%), corpus callosum (n = 11; 13.9%), periependymal-third ventricle (n = 9; 11.3%), corticospinal tract (n = 7; 8.8%), hemispheric white matter (n = 1; 1.2%) and nonspecific areas (n = 49; 62.03%). Asymptomatic BMRI lesions were more common. The frequency of brain MRI abnormalities did not differ between patients who were positive and negative for aquaporin 4 antibodies at presentation.

Conclusion: Typical brain MRI abnormalities are frequent in NMOSD at disease onset.

Keywords: Latin America; Magnetic resonance imaging; Neuromyelitis optica spectrum disorders; Typical MRI abnormalities.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aquaporin 4 / immunology*
  • Argentina
  • Autoantibodies / blood*
  • Brain / diagnostic imaging
  • Brain / pathology*
  • Brain Stem / diagnostic imaging
  • Brain Stem / pathology
  • Brazil
  • Cerebellum / diagnostic imaging
  • Cerebellum / pathology
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neuromyelitis Optica / blood*
  • Neuromyelitis Optica / diagnostic imaging
  • Neuromyelitis Optica / pathology*
  • Retrospective Studies
  • Venezuela
  • Young Adult

Substances

  • AQP4 protein, human
  • Aquaporin 4
  • Autoantibodies