Differences in Advanced Magnetic Resonance Imaging in MOG-IgG and AQP4-IgG Seropositive Neuromyelitis Optica Spectrum Disorders: A Comparative Study

Felix A Schmidt; Claudia Chien; Joseph Kuchling; Judith Bellmann-Strobl; Klemens Ruprecht; Nadja Siebert; Susanna Asseyer; Sven Jarius; Alexander U Brandt; Michael Scheel; Friedemann Paul

doi:10.3389/fneur.2020.499910

Differences in Advanced Magnetic Resonance Imaging in MOG-IgG and AQP4-IgG Seropositive Neuromyelitis Optica Spectrum Disorders: A Comparative Study

Front Neurol. 2020 Sep 30:11:499910. doi: 10.3389/fneur.2020.499910. eCollection 2020.

Authors

Felix A Schmidt^{1

2

3

4}, Claudia Chien¹, Joseph Kuchling^{1

2}, Judith Bellmann-Strobl^{1

5}, Klemens Ruprecht^{2

3}, Nadja Siebert^{1

5}, Susanna Asseyer^{1

5}, Sven Jarius⁶, Alexander U Brandt^{1

5

7}, Michael Scheel^{1

4

8}, Friedemann Paul^{1

2

5}

Affiliations

¹ NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
² Department of Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
³ Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
⁴ Berlin Institute of Health, Berlin, Germany.
⁵ Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
⁶ Division of Molecular Neuroimmunology, Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany.
⁷ Department of Neurology, University of California, Irvine, Irvine, CA, United States.
⁸ Department of Neuroradiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Abstract

Aims: To explore differences in advanced brain magnetic resonance imaging (MRI) characteristics between myelin oligodendrocyte (MOG) immunoglobulin (IgG) and aquaporin-4 (AQP4) IgG seropositive (+) neuromyelitis optica spectrum disorders (NMOSD). Methods: 33 AQP4-IgG and 18 MOG-IgG seropositive NMOSD patients and 61 healthy control (HC) subjects were included. All 112 participants were scanned with the same standardized MRI-protocol on a 3-Tesla MRI-scanner. Brain volume and diffusion tensor imaging (DTI) parameters were assessed. Results: MOG-IgG+ patients showed reduced parallel diffusivity within white matter tracts compared to HC whereas AQP4-IgG+ showed no significant brain parenchymal damage in DTI analysis. AQP4-IgG+ patients showed reduced whole brain volumes and reduced volumes of several deep gray matter structures compared to HC whereas MOG-IgG+ patients did not show reduced brain or deep gray matter volumes compared to HC. Conclusions: Microstructural brain parenchymal damage in MOG-IgG+ patients was more pronounced than in AQP4-IgG+ patients, compared with HC, whereas normalized brain volume reduction was more severe in AQP4-IgG+ patients. Longitudinal imaging studies are warranted to further investigate this trend in NMOSD. Our results suggest that MOG-IgG+ and AQP4-IgG+ NMOSD patients differ in cerebral MRI characteristics. Advanced MRI analysis did not help to differentiate between MOG-IgG+ and AQP4-IgG+ patients in our study.

Keywords: AQP4; DTI; MOG; MRI; NMOSD; advanced imaging.