Low myo-inositol indicating astrocytic damage in a case series of NMO

This study looked at five Neuromyelitis Optica (NMO)-related cases, with longitudinally extensive lesions in the upper cervical cord who underwent 1 H-MR spectroscopy of the cervical cord. NMO is a disease primarily of astrocytes, due to antibodies against aquaporin-4(AQP4-Abs), expressed at the astrocytic perivascular endfeet. As a result of the interaction between AQP4-Abs and aquaporin-4, this induces oedema, inflammation, demyelination and astrocytic necrosis. 

The researchers found lower myo-inositol/creatine values within the NMO lesions when compared with healthy controls and patients with MS, suggesting astrocytic damage. Myo-inositol is considered a marker of astrocytic activation and proliferation, therefore its reduction is likely to reflect astrocytic necrosis. The levels of myo-inositol of cervical cord lesions can discriminate between NMO/NMO spectrum disorders and MS. This may potentially have very important diagnostic implications as well as future value as imaging markers in clinical trials in NMO with remyelinating or neuroprotective agents. 

Authors: Ciccarelli O, Thomas D, De Vita E
Source: Ann Neurol. 2013 Apr 3. doi: 10.1002/ana.23909. [Epub ahead of print]

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