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Updated: May 12, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
T1 hypointense brain lesions in NMOSD and its relevance with disability: a single institution cross-sectional study
Mohamad Ghazanfari Hashemi1, Vahid Talebi1, Naghmeh Abbasi Kasbi1
1Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Neurology Department, Sina Hospital, Tehran, Iran.
Background:
T1 hypointense lesions are considered a surrogate marker of tissue destruction. Although there is a shortage of evidence about T1 hypointense brain lesions, black holes, in patients with Neuromyelitis Optica Spectrum Disorder (NMOSD), the clinical significance of these lesions is not well determined.
Objectives:
The impact of T1 hypointense brain lesions on the clinical status and the disability level of patients with NMOSD was sought in this study.
Methods:
A total of 83 patients with the final diagnosis of NMOSD were recruited. Aquaporin-4 measures were collected. The expanded disability status scale (EDSS) and MRI studies were also extracted. T1 hypointense and T2/FLAIR hyperintense lesions were investigated. The correlation of MRI findings, AQP-4, and EDSS was assessed.
Results:
T1 hypointense brain lesions were detected in 22 patients. Mean ± SD EDSS was 3.7 ± 1.5 and significantly higher in patients with brain T1 hypointense lesions than those without them (p-value = 0.01). Noticeably, patients with more than four T1 hypointense lesions had EDSS scores ≥ 4. The presence of T2/FLAIR hyperintense brain lesions correlated with EDSS (3.6 ± 1.6 vs 2.3 ± 1.7; p-value = 0.01). EDSS was similar between those with and without positive AQP-4 (2.7 ± 1.6 vs. 3.2 ± 1.7; p-value = 0.17). Also, positive AQP-4 was not more prevalent in patients with T1 hypointense brain lesions than those without them (50.9 vs 45.4%; p-value = 0.8).
Conclusion:
We demonstrated that the presence of the brain T1-hypointense lesions corresponds to a higher disability level in NMOSD.
