The usefulness of brain MRI at onset in the differentiation of MS and seropositive NMO spectrum disorders

This retrospective study investigated if brain MRI at onset can be useful in the differentiation of MS and NMO spectrum disorders (NMOSD) in 51 people with MS and 67 anti-aquaporin4-antibody-positive patients with NMOSD.

The researchers found that 37% of people with NMOSD met the Paty criteria, while 13% met the Barkhof criteria and 9% met the MAGNIMS criteria. This shows that it is difficult to differentiate MS from NMOSD, only by fulfilling the MRI criteria for MS on brain MRI at onset. Ovid lesions perpendicular to the lateral ventricle, isolated juxtacortical lesions in U-fibers and isolated ovid/round cortical lesions were found only in people with MS. Several lesions including longitudinal corticospinal tract lesions, extensive hemispheric lesions, periependymal lesions surrounding the lateral ventricles and cervicomedullary lesions are characteristic of NMO and can be helpful for differentiating NMOSD from MS based on brain MRI at onset. Overall, this study shows that the characteristic morphology of brain lesions is very useful for the early differentiation of MS from NMOSD. It is difficult to differentiate MS from NMOSD using the MRI criteria for MS on brain MRI.

Authors: Huh SY, Min JH
Source: Mult Scler. 2013 Sep 26. [Epub ahead of print]

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