RT Journal Article
SR Electronic
T1 Brain lesion distribution criteria distinguish MS from AQP4-antibody NMOSD and MOG-antibody disease
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 132
OP 136
DO 10.1136/jnnp-2016-314005
VO 88
IS 2
A1 Maciej Juryńczyk
A1 George Tackley
A1 Yazhuo Kong
A1 Ruth Geraldes
A1 Lucy Matthews
A1 Mark Woodhall
A1 Patrick Waters
A1 Wilhelm Kuker
A1 Matthew Craner
A1 Andrew Weir
A1 Gabriele C DeLuca
A1 Stephane Kremer
A1 Maria Isabel Leite
A1 Angela Vincent
A1 Anu Jacob
A1 Jérôme de Sèze
A1 Jacqueline Palace
YR 2017
UL http://jnnp.bmj.com/content/88/2/132.abstract
AB Importance Neuromyelitis optica spectrum disorders (NMOSD) can present with very similar clinical features to multiple sclerosis (MS), but the international diagnostic imaging criteria for MS are not necessarily helpful in distinguishing these two diseases.Objective This multicentre study tested previously reported criteria of ‘(1) at least 1 lesion adjacent to the body of the lateral ventricle and in the inferior temporal lobe; or (2) the presence of a subcortical U-fibre lesion or (3) a Dawson's finger-type lesion’ in an independent cohort of relapsing-remitting multiple sclerosis (RRMS) and AQP4-ab NMOSD patients and also assessed their value in myelin oligodendrocyte glycoprotein (MOG)-ab positive and ab-negative NMOSD.Design Brain MRI scans were anonymised and scored on the criteria by 2 of 3 independent raters. In case of disagreement, the final opinion was made by the third rater.Participants 112 patients with NMOSD (31 AQP4-ab-positive, 21 MOG-ab-positive, 16 ab-negative) or MS (44) were selected from 3 centres (Oxford, Strasbourg and Liverpool) for the presence of brain lesions.Results MRI brain lesion distribution criteria were able to distinguish RRMS with a sensitivity of 90.9% and with a specificity of 87.1% against AQP4-ab NMOSD, 95.2% against MOG-ab NMOSD and 87.5% in the heterogenous ab-negative NMOSD cohort. Over the whole NMOSD group, the specificity was 89.7%.Conclusions This study suggests that the brain MRI criteria for differentiating RRMS from NMOSD are sensitive and specific for all phenotypes.