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Elucidating distinct clinico-radiologic signatures in the borderland between neuromyelitis optica and multiple sclerosis | |
Jurynczyk, Maciej1,2; Klimiec-Moskal, Elzbieta1,3; Kong, Yazhuo4,5,6; Hurley, Samuel4; Messina, Silvia1; Yeo, Tianrong1; Jenkinson, Mark4; Leite, Maria Isabel1; Palace, Jacqueline1 | |
第一作者 | Jurynczyk, Maciej |
通讯作者邮箱 | m.jurynczyk@nencki.edu.pl (maciej juryńczyk ) ; jacqueline.palace@ndnc.ox.ac.uk (jacqueline palace ) |
心理所单位排序 | 5 |
摘要 | Background Separating antibody-negative neuromyelitis optica spectrum disorders (NMOSD) from multiple sclerosis (MS) in borderline cases is extremely challenging due to lack of biomarkers. Elucidating different pathologies within the likely heterogenous antibody-negative NMOSD/MS overlap syndrome is, therefore, a major unmet need which would help avoid disability from inappropriate treatment. Objective In this study we aimed to identify distinct subgroups within the antibody-negative NMOSD/MS overlap syndrome. Methods Twenty-five relapsing antibody-negative patients with NMOSD features underwent a prospective brain and spinal cord MRI. Subgroups were identified by an unsupervised algorithm based on pre-selected NMOSD/MS discriminators. Results Four subgroups were identified. Patients from Group 1 termed "MS-like" (n = 6) often had central vein sign and cortical lesions (83% and 67%, respectively). All patients from Group 2 ("spinal MS-like", 8) had short-segment myelitis and no MS-like brain lesions. Group 3 ("classic NMO-like", 6) had high percentage of bilateral optic neuritis and longitudinally extensive transverse myelitis (LETM, 80% and 60%, respectively) and normal brain appearance (100%). Group 4 ("NMO-like with brain involvement", 5) typically had a history of NMOSD-like brain lesions and LETM. When compared with other groups, Group 4 had significantly decreased fractional anisotropy in non-lesioned tracts (0.46 vs. 0.49, p = 0.003) and decreased thalamus volume (0.84 vs. 0.98, p = 0.04). Conclusions NMOSD/MS cohort contains distinct subgroups likely corresponding to different pathologies and requiring tailored treatment. We propose that non-conventional MRI might help optimise diagnosis in these challenging patients. |
关键词 | Multiple sclerosis Neuromyelitis optica Optic neuritis Myelitis Magnetic resonance imaging Prospective studies |
2021-05-27 | |
DOI | 10.1007/s00415-021-10619-1 |
发表期刊 | JOURNAL OF NEUROLOGY |
ISSN | 0340-5354 |
页码 | 11 |
期刊论文类型 | 实证研究 |
收录类别 | SCI |
资助项目 | Oxford University Hospitals Research and Development[A20069] ; John Fell Oxford University Press (OUP) Research Fund ; Polish Ministry of Science and Higher Education programme Mobilnosc Plus[1070/MOB/B/2013/0] ; NAWA Polish Returns programme[PPN/PPO/2020/1/00043/U/00001] ; Guarantors of Brain ; National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC) ; Wellcome Centre for Integrative Neuroimaging - Wellcome Trust[203139/Z/16/Z] |
出版者 | SPRINGER HEIDELBERG |
WOS关键词 | MYELIN-OLIGODENDROCYTE GLYCOPROTEIN ; SPECTRUM ; MRI ; SATRALIZUMAB ; ANTIBODIES ; DIAGNOSIS ; LESIONS ; MARKER |
WOS研究方向 | Neurosciences & Neurology |
WOS类目 | Clinical Neurology |
WOS记录号 | WOS:000655476200003 |
WOS分区 | Q1 |
引用统计 | |
文献类型 | 期刊论文 |
条目标识符 | http://ir.psych.ac.cn/handle/311026/39650 |
专题 | 中国科学院行为科学重点实验室 |
通讯作者 | Jurynczyk, Maciej; Palace, Jacqueline |
作者单位 | 1.Univ Oxford, Dept Clin Neurol, Nuffield Dept Clin Neurosci, Oxford, England 2.Polish Acad Sci, Neurobiol Ctr, Nencki Inst Expt Biol, Lab Brain Imaging, Warsaw, Poland 3.Jagiellonian Univ Med Coll, Dept Neurol, Krakow, Poland 4.Univ Oxford, Wellcome Ctr Integrat Neuroimaging, Nuffield Dept Clin Neurosci, Oxford, England 5.Chinese Acad Sci, Inst Psychol, CAS Key Lab Behav Sci, Beijing 100101, Peoples R China 6.Univ Chinese Acad Sci, Dept Psychol, Beijing 100049, Peoples R China |
推荐引用方式 GB/T 7714 | Jurynczyk, Maciej,Klimiec-Moskal, Elzbieta,Kong, Yazhuo,et al. Elucidating distinct clinico-radiologic signatures in the borderland between neuromyelitis optica and multiple sclerosis[J]. JOURNAL OF NEUROLOGY,2021:11. |
APA | Jurynczyk, Maciej.,Klimiec-Moskal, Elzbieta.,Kong, Yazhuo.,Hurley, Samuel.,Messina, Silvia.,...&Palace, Jacqueline.(2021).Elucidating distinct clinico-radiologic signatures in the borderland between neuromyelitis optica and multiple sclerosis.JOURNAL OF NEUROLOGY,11. |
MLA | Jurynczyk, Maciej,et al."Elucidating distinct clinico-radiologic signatures in the borderland between neuromyelitis optica and multiple sclerosis".JOURNAL OF NEUROLOGY (2021):11. |
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