Cognitive impairment and cortical degeneration in neuromyelitis optica

Saji, Etsuji; Arakawa, Masato; Yanagawa, Kaori; Toyoshima, Yasuko; Yokoseki, Akio; Okamoto, Kouichirou; Otsuki, Mika; Akazawa, Kohei; Kakita, Akiyoshi; Takahashi, Hitoshi; Nishizawa, Masatoyo; Kawachi, Izumi

doi:10.1002/ana.23721

Cited by 143 publications

(237 citation statements)

References 49 publications

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“…These impaired cognitive domains have frequently been reported in patients with NMO. 10,18,[21][22][23][24] However, inconsistent with previous studies that reported deficits in immediate memory, attention, and executive abilities, 10,17,18,21,23,24 we did not find any significant changes in these 3 cognitive domains in the patients with NMO. This discrepancy may be related to variations in the sample size, demographic and clinical features, and cognitive scales used.…”

Section: Discussioncontrasting

confidence: 99%

“…We found that the intergroup GMV differences were similar before and after excluding these patients (On-line Fig 3), suggesting that the impact of comorbidities on the intergroup GMV comparisons was not significant. Consistent with prior findings, 10,17,18,[21][22][23][24] we also found cognitive impairment in the patients with NMO. The cognitive impairments in NMO were deficits in short-and long-term memory, speed of information processing, and verbal fluency on semantic stimuli.…”

Section: Discussionsupporting

confidence: 92%

“…This hypothesis is confirmed by the results of a pathologic study that revealed a substantial cortical neuronal loss in NMO spectrum disorders. 24 The frontal cortex and thalamus are closely associated with cognitive function. 10,15,18,[33][34][35] The GMV reductions in these regions may affect cognitive performance.…”

Section: Discussionmentioning

confidence: 99%

“…Cognitive impairment has been repeatedly reported in patients with NMO 10,17,18,[21][22][23][24] and is characterized by deficits in multiple cognitive domains, including memory, attention, and speed of information processing. The neural correlates of the cognitive impairment in NMO have been attributed to focal reductions in white matter volume and integrity.…”

mentioning

confidence: 99%

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Gray Matter Volume Reduction Is Associated with Cognitive Impairment in Neuromyelitis Optica

Wang¹,

Zhang²,

Qin³

et al. 2015

AJNR Am J Neuroradiol

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Gray Matter Volume Reduction Is Associated with Cognitive Impairment in Neuromyelitis Optica

Wang¹,

Zhang²,

Qin³

et al. 2015

AJNR Am J Neuroradiol

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“…7 Lesion probability maps have not found statistically significant lesion locations in patients positive for anti-AQP4 antibody over those with MS. 6 However, distinguishing features were identified on MS brain MRI that were sensitive and specific, such as the presence of a lateral ventricle and inferior temporal lobe lesion, Dawson fingers, or an S-shaped U-fiber lesion, to classify the patient as MS. Imaging sensitive to cortical lesions has revealed their absence in NMO (excluding one Japanese study of NMO pathology 48 ), whereas they are seen in the majority of patients with MS. 49,50 Characteristic MS brain lesions surround central venule in .80% on high-strength MRI. 50,51 In NMO lesions, this is less frequent, reported in 9% to 35% of cases 50,52 and likely indicates the different pathogenic mechanisms of the disease.…”

Section: Comparing the Imaging Of Nmosd Withmentioning

confidence: 99%

MRI characteristics of neuromyelitis optica spectrum disorder

et al. 2015

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Since its initial reports in the 19th century, neuromyelitis optica (NMO) had been thought to involve only the optic nerves and spinal cord. However, the discovery of highly specific antiaquaporin-4 antibody diagnostic biomarker for NMO enabled recognition of more diverse clinical spectrum of manifestations. Brain MRI abnormalities in patients seropositive for anti-aquaporin-4 antibody are common and some may be relatively unique by virtue of localization and configuration. Some seropositive patients present with brain involvement during their first attack and/or continue to relapse in the same location without optic nerve and spinal cord involvement. Thus, characteristics of brain abnormalities in such patients have become of increased interest. In this regard, MRI has an increasingly important role in the differential diagnosis of NMO and its spectrum disorder (NMOSD), particularly from multiple sclerosis. Differentiating these conditions is of prime importance because early initiation of effective immunosuppressive therapy is the key to preventing attack-related disability in NMOSD, whereas some disease-modifying drugs for multiple sclerosis may exacerbate the disease. Therefore, identifying the MRI features suggestive of NMOSD has diagnostic and prognostic implications. We herein review the brain, optic nerve, and spinal cord MRI findings of NMOSD. Neuromyelitis optica (NMO) is an inflammatory disease of the CNS that is characterized by severe attacks of optic neuritis (ON) and longitudinally extensive transverse myelitis (LETM). 1The past decade has witnessed dramatic advances in our understanding of NMO. Such advances were initiated by the discovery of the disease-specific autoantibody, NMO-immunoglobulin G (NMO-IgG), and subsequent identification of the main target autoantigen, aquaporin-4 (AQP4), which has distinguished NMO as a distinct disease from multiple sclerosis (MS). 2Current diagnostic criteria, however, still require both ON and myelitis for an NMO diagnosis.3 Nevertheless, the identification of anti-AQP4 antibodies beyond the current diagnostic criteria of NMO indicates a broader clinical phenotype of this disorder, so-called "NMO spectrum disorder" (NMOSD). 4,5 The NMOSD encompasses anti-AQP4 antibody seropositive patients with limited or inaugural forms of NMO and with specific brain abnormalities. It also includes anti-AQP4 antibody seropositive patients with other autoimmune disorders such as systemic

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Use of Advanced Magnetic Resonance Imaging Techniques in Neuromyelitis Optica Spectrum Disorder

et al. 2015

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Brain parenchymal lesions are frequently observed on conventional magnetic resonance imaging (MRI) scans of patients with neuromyelitis optica (NMO) spectrum disorder, but the specific morphological and temporal patterns distinguishing them unequivocally from lesions caused by other disorders have not been identified. This literature review summarizes the literature on advanced quantitative imaging measures reported for patients with NMO spectrum disorder, including proton MR spectroscopy, diffusion tensor imaging, magnetization transfer imaging, quantitative MR volumetry, and ultrahigh-field strength MRI. It was undertaken to consider the advanced MRI techniques used for patients with NMO by different specialists in the field.Although quantitative measures such as proton MR spectroscopy or magnetization transfer imaging have not reproducibly revealed diffuse brain injury, preliminary data from diffusionweighted imaging and brain tissue volumetry indicate greater white matter than gray matter degradation. These findings could be confirmed by ultrahigh-field MRI. The use of nonconventional MRI techniques may further our understanding of the pathogenic processes in NMO spectrum disorders and may help us identify the distinct radiographic features corresponding to specific phenotypic manifestations of this disease.

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Cognitive impairment and cortical degeneration in neuromyelitis optica

Cited by 143 publications

References 49 publications

Gray Matter Volume Reduction Is Associated with Cognitive Impairment in Neuromyelitis Optica

Gray Matter Volume Reduction Is Associated with Cognitive Impairment in Neuromyelitis Optica

MRI characteristics of neuromyelitis optica spectrum disorder

Use of Advanced Magnetic Resonance Imaging Techniques in Neuromyelitis Optica Spectrum Disorder

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