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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
First AuthorJurynczyk, Maciej
Correspondent Emailm.jurynczyk@nencki.edu.pl (maciej juryńczyk ) ; jacqueline.palace@ndnc.ox.ac.uk (jacqueline palace )
Contribution Rank5
Abstract

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.

KeywordMultiple sclerosis Neuromyelitis optica Optic neuritis Myelitis Magnetic resonance imaging Prospective studies
2021-05-27
DOI10.1007/s00415-021-10619-1
Source PublicationJOURNAL OF NEUROLOGY
ISSN0340-5354
Pages11
Subtype实证研究
Indexed BySCI
Funding ProjectOxford 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]
PublisherSPRINGER HEIDELBERG
WOS KeywordMYELIN-OLIGODENDROCYTE GLYCOPROTEIN ; SPECTRUM ; MRI ; SATRALIZUMAB ; ANTIBODIES ; DIAGNOSIS ; LESIONS ; MARKER
WOS Research AreaNeurosciences & Neurology
WOS SubjectClinical Neurology
WOS IDWOS:000655476200003
WoS QuartileQ1
Citation statistics
Document Type期刊论文
Identifierhttp://ir.psych.ac.cn/handle/311026/39650
Collection中国科学院行为科学重点实验室
Corresponding AuthorJurynczyk, Maciej; Palace, Jacqueline
Affiliation1.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
Recommended Citation
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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