Structural brain abnormalities are related to retinal nerve fiber layer thinning and disease duration in neuromyelitis optica spectrum disorders

• Published in: Multiple sclerosis Vol. 20; no. 9; pp. 1189 - 1197
• Main Authors: von Glehn, Felipe, Jarius, Sven, Cavalcanti Lira, Rodrigo Pessoa, Alves Ferreira, Maria Carolina, von Glehn, Fadua H Ribeiro, Costa e Castro, Stella Maris, Beltramini, Guilherme Coco, Bergo, Felipe PG, Farias, Alessandro S, Brandão, Carlos Otávio, Wildemann, Brigitte, Damasceno, Benito P, Cendes, Fernando, Santos, Leonilda M B, Yasuda, Clarissa Lin
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.08.2014; Sage Publications; Sage Publications Ltd
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Case-Control Studies; Cerebrospinal fluid. Meninges. Spinal cord; Cross-Sectional Studies; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Diffusion Tensor Imaging; Diseases of visual field, optic nerve, optic chiasma and optic tracts; Female; Gray Matter - diagnostic imaging; Humans; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Nervous system (semeiology, syndromes); Neurology; Neuromyelitis Optica - diagnostic imaging; Ophthalmology; Optic Nerve - diagnostic imaging; Predictive Value of Tests; Prognosis; Tomography, Optical Coherence; White Matter - diagnostic imaging; Young Adult; optical coherence tomography analysis; longitudinally extensive transverse myelitis; Neuromyelitis optica; VBM analysis; retinal nerve fiber layer atrophy; Multiple sclerosis; Optical coherence tomography; Central nervous system; Neurooptic myelitis; Retina; Inflammatory disease; Encephalon; Transverse myelitis; Eye; Atrophy; Visual system; Visual pathway; Degenerative disease; Nerve fiber; Nervous system diseases; Optic nerve; Eye disease; Cranial nerve disease; Central nervous system disease; Spinal cord disease
• ISSN: 1352-4585; 1477-0970; 1477-0970
• DOI: 10.1177/1352458513519838

Background: Although aquaporin-4 (AQP4) is widely expressed in the human brain cortex, lesions are rare in neuromyelitis optica (NMO) spectrum disorders (NMOSD). Recently, however, several studies have demonstrated occult structural brain atrophy in NMO. Objective: This study aims to investigate magnetic resonance imaging (MRI) patterns of gray matter (GM) and white matter (WM) abnormalities in patients with NMOSD and to assess the visual pathway integrity during disease duration correlation of the retinal nerve fiber layer (RNFL) and pericalcarine cortex thickness. Methods: Twenty-one patients with NMOSD and 34 matched healthy controls underwent both high-field MRI (3T) high-resolution T1-weighted and diffusion-tensor MRI. Voxel-based morphometry, cortical analyses (Freesurfer) and diffusion-tensor imaging (DTI) analyses (TBSS-FSL) were used to investigate brain abnormalities. In addition, RNFL measurement by optic-coherence tomography (OCT) was performed. Results: We demonstrate that NMOSD is associated with GM and WM atrophy, encompassing more frequently the motor, sensory and visual pathways, and that the extent of GM atrophy correlates with disease duration. Furthermore, we demonstrate for the first time a correlation between RNFL and pericalcarine cortical thickness, with cortical atrophy evolving over the course of disease. Conclusions: Our findings indicate a role for retrograde and anterograde neurodegeneration in GM atrophy in NMOSD. However, the presence atrophy encompassing almost all lobes suggests that additional pathomechanisms might also be involved.