title: Advanced magnetic resonance imaging of neuromyelitis optica: a multiparametric approach.
abstract: BACKGROUND
  Several authors have used advanced magnetic resonance imaging (MRI) techniques to investigate whether patients with neuromyelitis optica (NMO) have occult damage in normal-appearing brain tissue, similarly to multiple sclerosis (MS). To date, the literature contains no data derived from the combined use of several advanced MRI techniques in the same NMO subjects.
  
  
  OBJECTIVE
  We set out to determine whether occult damage could be detected in the normal-appearing brain tissue of a small group of patients with NMO using a multiparametric MRI approach.
  
  
  METHODS
  Eight female patients affected by NMO (age range 44-58 years) and seven sex- and age-matched healthy controls were included. The techniques used on a 1.5 T MRI imaging scanner were magnetization transfer imaging, diffusion tensor imaging, tract-based spatial statistics, spectroscopy and voxel-based morphometry in order to analyse normal-appearing white matter and normal-appearing grey matter.
  
  
  RESULTS
  Structural and metabolic parameters showed no abnormalities in normal-appearing white matter of patients with NMO. Conversely, tract-based spatial statistics demonstrated a selective alteration of the optic pathways and the lateral geniculate nuclei. Diffusion tensor imaging values in the normal-appearing grey matter were found to be significantly different in the patients with NMO versus the healthy controls. Moreover, voxel-based morphometry analysis demonstrated a significant density and volume reduction of the sensorimotor cortex and the visual cortex.
  
  
  CONCLUSIONS
  Our data disclosed occult structural damage in the brain of patients with NMO, predominantly involving regions connected with motor and visual systems. This damage seems to be the direct consequence of transsynaptic degeneration triggered by lesions of the optic nerve and spine.
authors.affiliation: Neuroradiology Department, IRCCS National Neurological Institute IRCCS C Mondino, Pavia, Italy. anna.pichiecchio@mondino.it
authors.forename: A
authors.initials: A
authors.lastname: Pichiecchio
authors.forename: E
authors.initials: E
authors.lastname: Tavazzi
authors.forename: G
authors.initials: G
authors.lastname: Poloni
authors.forename: M
authors.initials: M
authors.lastname: Ponzio
authors.forename: F
authors.initials: F
authors.lastname: Palesi
authors.forename: M
authors.initials: M
authors.lastname: Pasin
authors.forename: L
authors.initials: L
authors.lastname: Piccolo
authors.forename: D
authors.initials: D
authors.lastname: Tosello
authors.forename: A
authors.initials: A
authors.lastname: Romani
authors.forename: R
authors.initials: R
authors.lastname: Bergamaschi
authors.forename: G
authors.initials: G
authors.lastname: Piccolo
authors.forename: S
authors.initials: S
authors.lastname: Bastianello
mesh_terms: D000328:Adult; D001921:Brain / Q000378:metabolism / Q000473:pathology*; D016022:Case-Control Studies; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D007558:Italy; D009682:Magnetic Resonance Spectroscopy; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D009900:Optic Nerve / Q000473:pathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013116:Spinal Cord / Q000473:pathology