Cervical spinal cord atrophy in NMOSD without a history of myelitis or MRI-visible lesions

Ventura, Rachel E.; Kister, Ilya; Chung, Sohae; Babb, James S.; Shepherd, Timothy M.

doi:10.1212/nxi.0000000000000224

Cited by 55 publications

(56 citation statements)

References 8 publications

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“…Astrocytic dysfunction could lead to neuroaxonal damage in the retina and other affected brain regions, as has been reported in brainstem and chiasm, which was recently also shown in animal models of NMOSD 18 32. Microstructural changes have been reported in biopsies from spinal cord lesions,33 in spinal cord atrophy in AQP4-ab seropositive patients with NMOSD without previous myelitis34 and fovea thickness as well as optic radiation changes in AQP4-ab seropositive patients without previous ON16– all suggesting a primary astrocytopathy.…”

Section: Discussionmentioning

confidence: 94%

Retinal ganglion cell loss in neuromyelitis optica: a longitudinal study

Oertel

Havla

Roca-Fernández

et al. 2018

J Neurol Neurosurg Psychiatry

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This study clearly shows GCIP loss independent of ON attacks in aquaporin4-antibody-seropositive NMOSD. Potential explanations for progressive GCIP thinning include primary retinopathy, drug-induced neurodegeneration and retrograde neuroaxonal degeneration from lesions or optic neuropathy. pRNFL thickening in the patients presenting with attacks during F/U might be indicative of pRNFL susceptibility to inflammation.

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Section: Discussionmentioning

confidence: 94%

Retinal ganglion cell loss in neuromyelitis optica: a longitudinal study

Oertel

Havla

Roca-Fernández

et al. 2018

J Neurol Neurosurg Psychiatry

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“…Although secondary progressive disease was assumed to be uncommon in NMOSD, 3 recent studies relying on MRI findings have described progressive brain or spinal cord atrophy 4,5 without a sign of relapses in patients with AQP4Ab+ NMOSD.…”

mentioning

confidence: 99%

Foveal thinning in neuromyelitis optica

Yamamura

Nakashima²

2017

Neurol Neuroimmunol Neuroinflamm

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“…To elucidate the influence of brain lesions on spinal cord atrophy, spinal cord cross‐sectional areas and whole brain parenchymal volume and brain lesion volumes are now being prospectively measured in our cohort. Thirdly, although a recent study reported that cervical spinal cord atrophy developed in a small series of NMOSD patients without a clinical history of myelitis , NMOSD patients without a clinical history of myelitis were not included in the present study because of the small sample size. Finally, healthy controls were not included in the present study because the focus was on comparisons between MS and NMOSD.…”

Section: Discussionmentioning

confidence: 99%

Spinal cord involvement by atrophy and associations with disability are different between multiple sclerosis and neuromyelitis optica spectrum disorder

Nakamura¹,

Liu²,

Fukumoto³

et al. 2019

Euro J of Neurology

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Background and purpose The cervical and thoracic cross‐sectional spinal cord area (CS‐SCA) in multiple sclerosis (MS) correlates with disability, whilst such a correlation remains to be established in neuromyelitis optica spectrum disorder (NMOSD). Our aim was to clarify differences between MS and NMOSD in spinal cord segments where CS‐SCA is associated with disability. Methods The CS‐SCA at C2/C3, C3/C4, T8/T9 and T9/T10 vertebral disc levels was measured in 140 MS patients (111 with relapsing–remitting MS and 29 with progressive MS) and 42 NMOSD patients with anti‐aquaporin‐4 immunoglobulin G. Disability was evaluated by Expanded Disability Status Scale (EDSS) scores. Multivariate associations between CS‐SCA and disability were assessed by stepwise forward multiple linear regression. Results Thoracic CS‐SCA was significantly smaller in NMOSD patients than in MS patients even after adjusting for age, sex and disease duration (P = 0.002 at T8/T9), whilst there was no difference in cervical CS‐SCA between the two diseases. Cervical and thoracic CS‐SCA had a negative correlation with EDSS scores in MS patients (P < 0.0001 at C3/C4 and P = 0.0002 at T8/T9) whereas only thoracic CS‐SCA correlated with EDSS scores in NMOSD patients (P = 0.0006 at T8/T9). By multiple regression analyses, predictive factors for disability in MS were smaller cervical CS‐SCA, progressive course, older age and a higher number of relapses, whilst those in NMOSD were smaller thoracic CS‐SCA and older age. Conclusions Thoracic CS‐SCA is a useful predictive marker for disability in patients with NMOSD whilst cervical CS‐SCA is associated with disability in patients with MS.

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Cervical spinal cord atrophy in NMOSD without a history of myelitis or MRI-visible lesions

Cited by 55 publications

References 8 publications

Retinal ganglion cell loss in neuromyelitis optica: a longitudinal study

Retinal ganglion cell loss in neuromyelitis optica: a longitudinal study

Foveal thinning in neuromyelitis optica

Spinal cord involvement by atrophy and associations with disability are different between multiple sclerosis and neuromyelitis optica spectrum disorder

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