title: Distinction of seropositive NMO spectrum disorder and MS brain lesion distribution.
abstract: OBJECTIVE
  Neuromyelitis optica and its spectrum disorder (NMOSD) can present similarly to relapsing-remitting multiple sclerosis (RRMS). Using a quantitative lesion mapping approach, this research aimed to identify differences in MRI brain lesion distribution between aquaporin-4 antibody-positive NMOSD and RRMS, and to test their diagnostic potential.
  
  
  METHODS
  Clinical brain MRI sequences for 44 patients with aquaporin-4 antibody-positive NMOSD and 50 patients with RRMS were examined for the distribution and morphology of brain lesions. T2 lesion maps were created for each subject allowing the quantitative comparison of the 2 conditions with lesion probability and voxel-wise analysis.
  
  
  RESULTS
  Sixty-three percent of patients with NMOSD had brain lesions and of these 27% were diagnostic of multiple sclerosis. Patients with RRMS were significantly more likely to have lesions adjacent to the body of the lateral ventricle than patients with NMOSD. Direct comparison of the probability distributions and the morphologic attributes of the lesions in each group identified criteria of "at least 1 lesion adjacent to the body of the lateral ventricle and in the inferior temporal lobe; or the presence of a subcortical U-fiber lesion; or a Dawson's finger-type lesion," which could distinguish patients with multiple sclerosis from those with NMOSD with 92% sensitivity, 96% specificity, 98% positive predictive value, and 86% negative predictive value.
  
  
  CONCLUSIONS
  Careful inspection of the distribution and morphology of MRI brain lesions can distinguish RRMS and NMOSD.
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, UK. lucy.matthews@ndcn.ox.ac.uk
authors.forename: Lucy
authors.initials: L
authors.lastname: Matthews
authors.forename: Rita
authors.initials: R
authors.lastname: Marasco
authors.forename: Mark
authors.initials: M
authors.lastname: Jenkinson
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Küker
authors.forename: Sebastian
authors.initials: S
authors.lastname: Luppe
authors.forename: Maria Isabel
authors.initials: MI
authors.lastname: Leite
authors.forename: Antonio
authors.initials: A
authors.lastname: Giorgio
authors.forename: Nicola
authors.initials: N
authors.lastname: De Stefano
authors.forename: Neil
authors.initials: N
authors.lastname: Robertson
authors.forename: Heidi
authors.initials: H
authors.lastname: Johansen-Berg
authors.forename: Nikos
authors.initials: N
authors.lastname: Evangelou
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Palace
mesh_terms: D000328:Adult; D000368:Aged; D051401:Aquaporin 4 / Q000276:immunology; D001323:Autoantibodies / Q000097:blood*; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000097:blood / Q000175:diagnosis*; D009471:Neuromyelitis Optica / Q000097:blood / Q000175:diagnosis*; D011336:Probability; D055815:Young Adult
chemical_list: C496030:AQP4 protein, human; D051401:Aquaporin 4; D001323:Autoantibodies