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Brain and spinal cord lesion criteria distinguishes AQP4-positive neuromyelitis optica and MOG-positive disease from multiple sclerosis.
Mult Scler Relat Disord 2018; 25:246-250MS

Abstract

OBJECTIVE

Test the ability of a brain and spinal cord MRI criteria to differentiate neuromyelitis optica spectrum disorders and MOG-disease from MS. MRI criteria was further tested in patients with CIS and pediatric MS.

BACKGROUND

MOG-disease and neuromyelitis optica spectrum disorders can present clinical and radiological features strikingly similar to those of MS. Previously, diagnostic criteria based on brain MRI have been proposed to distinguish between these demyelinating diseases (Matthews-Jurynczik criteria), but spinal cord imaging and its relevance in CIS have not been evaluated. Simple brain and spinal cord MRI criteria may help separate these three inflammatory CNS diseases both in adults and children, aiding in early diagnostic decision-making, such as need for antibody testing.

DESIGN/METHODS

We included 150 participants (23 with aquaporin-4-positive neuromyelitis optica spectrum disorder, 14 with MOG-disease, 20 with aquaporin-4-negative neuromyelitis optica spectrum disorder, 48 with adult-onset relapsing remitting MS, 24 with pediatric-onset MS and 21 with clinically isolated syndrome). Brain and spinal cord MRI scans were anonymised and scored by 2 separate raters, based on two sets of criteria: one previously described by Matthews and colleagues (including presence of at least one lesion adjacent to the body of lateral ventricle and in the inferior temporal lobe, or presence of subcortical U-fiber lesion or a Dawson's finger-type lesion), and an extended version including spinal cord features (non-longitudinally extensive cervical lesion).

RESULTS

Extended MRI brain and spinal cord lesion criteria were able to separate adult-onset relapsing remitting MS with 100% sensitivity and 87% specificity from aquaporin-4-positive neuromyelitis optica spectrum disorder; and with 100% sensitivity and 79% specificity from MOG-disease. Additionally, brain and spinal cord criteria showed 100% sensitivity and specificity in patients presenting optic neuritis. Brain and spinal cord criteria were less sensitive in patients with CIS and in pediatric MS patients.

CONCLUSIONS

Our data suggest radiological criteria can be useful to separate MS from MOG- and aquaporin-4-positive neuromyelitis optica spectrum disorders, in particular in patients with optic neuritis. Further work is needed to support their use in CIS.

Authors+Show Affiliations

Department of Neurology, Institute for Neurological Research Dr. Raúl Carrea (FLENI), Buenos Aires, Argentina.Department of Neurology, Institute for Neurological Research Dr. Raúl Carrea (FLENI), Buenos Aires, Argentina.Department of Neuropediatrics, Hospital Italiano de Buenos Aires (HIBA), Buenos Aires, Argentina.Department of Neurology, Hospital Británico de Buenos Aires, Buenos Aires, Argentina.Department of Diagnostic Imaging, Institute for Neurological Research Dr. Raúl Carrea (FLENI), Buenos Aires, Argentina.Department of Diagnostic Imaging, Institute for Neurological Research Dr. Raúl Carrea (FLENI), Buenos Aires, Argentina.Department of Neuropediatrics, Institute for Neurological Research Dr. Raúl Carrea (FLENI), Buenos Aires, Argentina.Department of Neurology, Institute for Neurological Research Dr. Raúl Carrea (FLENI), Buenos Aires, Argentina; Center for Research on Neuroimmunological Diseases (CIEN), Institute for Neurological Research Dr. Raúl Carrea (FLENI), Montañeses 2325, Buenos Aires, Argentina.Center for Research on Neuroimmunological Diseases (CIEN), Institute for Neurological Research Dr. Raúl Carrea (FLENI), Montañeses 2325, Buenos Aires, Argentina; Center for Biostatistics, Epidemiology and Public Health (CEBES), Institute for Neurological Research Dr. Raúl Carrea (FLENI), Buenos Aires, Argentina. Electronic address: mfarez@fleni.org.ar.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30144694

Citation

Bensi, C, et al. "Brain and Spinal Cord Lesion Criteria Distinguishes AQP4-positive Neuromyelitis Optica and MOG-positive Disease From Multiple Sclerosis." Multiple Sclerosis and Related Disorders, vol. 25, 2018, pp. 246-250.
Bensi C, Marrodan M, González A, et al. Brain and spinal cord lesion criteria distinguishes AQP4-positive neuromyelitis optica and MOG-positive disease from multiple sclerosis. Mult Scler Relat Disord. 2018;25:246-250.
Bensi, C., Marrodan, M., González, A., Chertcoff, A., Osa Sanz, E., Chaves, H., ... Farez, M. F. (2018). Brain and spinal cord lesion criteria distinguishes AQP4-positive neuromyelitis optica and MOG-positive disease from multiple sclerosis. Multiple Sclerosis and Related Disorders, 25, pp. 246-250. doi:10.1016/j.msard.2018.08.008.
Bensi C, et al. Brain and Spinal Cord Lesion Criteria Distinguishes AQP4-positive Neuromyelitis Optica and MOG-positive Disease From Multiple Sclerosis. Mult Scler Relat Disord. 2018;25:246-250. PubMed PMID: 30144694.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Brain and spinal cord lesion criteria distinguishes AQP4-positive neuromyelitis optica and MOG-positive disease from multiple sclerosis. AU - Bensi,C, AU - Marrodan,M, AU - González,A, AU - Chertcoff,A, AU - Osa Sanz,E, AU - Chaves,H, AU - Schteinschnaider,A, AU - Correale,J, AU - Farez,M F, Y1 - 2018/08/09/ PY - 2018/05/11/received PY - 2018/08/01/revised PY - 2018/08/07/accepted PY - 2018/8/26/pubmed PY - 2018/12/19/medline PY - 2018/8/26/entrez KW - MOG KW - Multiple sclerosis KW - Neuromyelitis optica KW - Neuromyelitis optica spectrum disorders SP - 246 EP - 250 JF - Multiple sclerosis and related disorders JO - Mult Scler Relat Disord VL - 25 N2 - OBJECTIVE: Test the ability of a brain and spinal cord MRI criteria to differentiate neuromyelitis optica spectrum disorders and MOG-disease from MS. MRI criteria was further tested in patients with CIS and pediatric MS. BACKGROUND: MOG-disease and neuromyelitis optica spectrum disorders can present clinical and radiological features strikingly similar to those of MS. Previously, diagnostic criteria based on brain MRI have been proposed to distinguish between these demyelinating diseases (Matthews-Jurynczik criteria), but spinal cord imaging and its relevance in CIS have not been evaluated. Simple brain and spinal cord MRI criteria may help separate these three inflammatory CNS diseases both in adults and children, aiding in early diagnostic decision-making, such as need for antibody testing. DESIGN/METHODS: We included 150 participants (23 with aquaporin-4-positive neuromyelitis optica spectrum disorder, 14 with MOG-disease, 20 with aquaporin-4-negative neuromyelitis optica spectrum disorder, 48 with adult-onset relapsing remitting MS, 24 with pediatric-onset MS and 21 with clinically isolated syndrome). Brain and spinal cord MRI scans were anonymised and scored by 2 separate raters, based on two sets of criteria: one previously described by Matthews and colleagues (including presence of at least one lesion adjacent to the body of lateral ventricle and in the inferior temporal lobe, or presence of subcortical U-fiber lesion or a Dawson's finger-type lesion), and an extended version including spinal cord features (non-longitudinally extensive cervical lesion). RESULTS: Extended MRI brain and spinal cord lesion criteria were able to separate adult-onset relapsing remitting MS with 100% sensitivity and 87% specificity from aquaporin-4-positive neuromyelitis optica spectrum disorder; and with 100% sensitivity and 79% specificity from MOG-disease. Additionally, brain and spinal cord criteria showed 100% sensitivity and specificity in patients presenting optic neuritis. Brain and spinal cord criteria were less sensitive in patients with CIS and in pediatric MS patients. CONCLUSIONS: Our data suggest radiological criteria can be useful to separate MS from MOG- and aquaporin-4-positive neuromyelitis optica spectrum disorders, in particular in patients with optic neuritis. Further work is needed to support their use in CIS. SN - 2211-0356 UR - https://www.unboundmedicine.com/medline/citation/30144694/Brain_and_spinal_cord_lesion_criteria_distinguishes_AQP4_positive_neuromyelitis_optica_and_MOG_positive_disease_from_multiple_sclerosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2211-0348(18)30275-X DB - PRIME DP - Unbound Medicine ER -