The cervical spinal cord in neuromyelitis optica patients: a comparative study with multiple sclerosis using...

Area of Science:

• Neuroimaging
• Neurology
• Radiology

Background:

• Neuromyelitis optica (NMO) is an autoimmune disease targeting the central nervous system.
• The integrity of normal-appearing spinal cord (NASC) in NMO is not fully understood.
• Comparing NMO spinal cord integrity to multiple sclerosis (MS) and healthy controls is crucial.

Purpose of the Study:

• To evaluate the in vivo integrity of the normal-appearing spinal cord (NASC) in neuromyelitis optica (NMO) patients.
• To compare spinal cord integrity in NMO patients with multiple sclerosis (MS) patients and healthy controls.
• To identify potential differences in spinal cord damage patterns between NMO and MS.

Main Methods:

• Diffusion tensor MR imaging was used to assess spinal cord integrity.
• Key diffusion metrics including Fractional Anisotropy (FA), Axial Diffusivity (AD), Radial Diffusivity (RD), and Mean Diffusivity (MD) were calculated.
• Regions of interest were analyzed at C2 and C7 levels across the four spinal cord columns.

Main Results:

• NMO patients exhibited decreased FA in the anterior column at C2 compared to MS and controls.
• Increased RD was observed in the anterior column at C2 in NMO patients versus MS and controls.
• At C7, NMO patients showed higher AD and MD in the right column compared to MS and controls.

Conclusions:

• Extensive damage to the normal-appearing spinal cord (NASC) white matter is present in NMO patients.
• This damage affects peripheral cervical spinal cord areas and is primarily attributed to demyelination.
• The findings suggest a distinct spinal cord lesion pattern in NMO compared to MS.