Normal-Appearing Cerebellar Damage in Neuromyelitis Optica Spectrum Disorder

Area of Science:

• Neuroscience
• Neurology
• Neuroimmunology

Background:

• The cerebellum is crucial for motor and cognitive functions.
• The impact of neuromyelitis optica spectrum disorder (NMOSD) on the normal-appearing cerebellum is not well understood.
• Occult structural damage in the cerebellum of NMOSD patients requires investigation.

Purpose of the Study:

• To identify subtle structural damage within the cerebellum of NMOSD patients.
• To determine the potential causes of this cerebellar damage at the substructure level.

Main Methods:

• Compared normal-appearing gray matter volumes of cerebellar lobules and nuclei between NMOSD patients and healthy controls.
• Compared normal-appearing white matter volumes of cerebellar peduncles between NMOSD patients and healthy controls.

Main Results:

• Cerebellar damage in specific lobules (VI, VIII, X) and nuclei was associated with spinal lesions or aquaporin-4 antibodies.
• Mixed cerebellar damage in lobules V, IX, Crus I, and VIIb showed primary associations with spinal lesions or aquaporin-4 antibodies.
• Other cerebellar substructures did not exhibit significant damage.

Conclusions:

• Cerebellar damage in NMOSD involves normal-appearing white and gray matter.
• Damage is linked to aquaporin-4-mediated injury, secondary axonal degeneration from spinal lesions, or both.
• Substructure-specific etiologic classifications can aid in developing neuroimaging markers for NMOSD severity and treatment assessment.