Distinction of seropositive NMO spectrum disorder and MS brain lesion distribution

In this study from the UK, the researchers looked at identifying differences in MRI brain lesion distribution between aquaporin-4 antibody-positive NMOSD (neuromyelitis optica and its spectrum disorder) and RRMS, using quantitative lesion mapping. They looked at 44 patients with aquaporin-4 antibody-positive NMOSD and 50 patients with RRMS. They created T2 lesion maps for each subject in order to compare the two disorders with lesion probability and voxel-wise analysis.

The researchers found that 63% of patients with NMOSD had brain lesions, and of these 27% were diagnostic of MS. When they compared the probability distributions and the morphologic attributes of the lesions in each group, the criteria of at least one lesion adjacent to the body of the lateral ventricle and in the inferior temporal lobe, or the presence of a subcortical U-fibre lesion or a Dawson’s finger-type lesion, could distinguish patients with MS from those with NMOSD with 92% sensitivity, 97% specificity, 98% positive predictive value and 86% negative predictive value. Therefore, the distribution and morphology of MRI brain lesions can distinguish RRMS and NMOSD.

Authors: Matthews L, Marasco R, Jenkinson M,

Source: Neurology. 2013 Mar 13. [Epub ahead of print]

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