title: Low myo-inositol indicating astrocytic damage in a case series of neuromyelitis optica.
abstract: Astrocytic necrosis is a prominent pathological feature of neuromyelitis optica (NMO) lesions and is clinically relevant. We report 5 NMO-related cases, all with longitudinally extensive lesions in the upper cervical cord, who underwent cervical cord (1) H-magnetic resonance spectroscopy. Lower myo-inositol/creatine values, suggesting astrocytic damage, were consistently found within the NMO lesions when compared with healthy controls and patients with multiple sclerosis (MS), who showed at least 1 demyelinating lesion at the same cord level. Therefore, the in vivo quantification of myo-inositol may distinguish NMO from MS. This is an important step toward developing imaging markers for clinical trials in NMO.
authors.affiliation: Department of Brain Repair and Rehabilitation, Nuclear Magnetic Resonance Research Unit, University College London Institute of Neurology, London; National Institute for Health Research, University College London Hospitals Biomedical Research Centre, London.
authors.forename: Olga
authors.initials: O
authors.lastname: Ciccarelli
authors.forename: David L
authors.initials: DL
authors.lastname: Thomas
authors.forename: Enrico
authors.initials: E
authors.lastname: De Vita
authors.forename: Claudia A M
authors.initials: CA
authors.lastname: Wheeler-Kingshott
authors.forename: Carolina
authors.initials: C
authors.lastname: Kachramanoglou
authors.forename: Raj
authors.initials: R
authors.lastname: Kapoor
authors.forename: Siobhan
authors.initials: S
authors.lastname: Leary
authors.forename: Lucy
authors.initials: L
authors.lastname: Matthews
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Palace
authors.forename: Declan
authors.initials: D
authors.lastname: Chard
authors.forename: David H
authors.initials: DH
authors.lastname: Miller
authors.forename: Ahmed T
authors.initials: AT
authors.lastname: Toosy
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Thompson
mesh_terms: D000328:Adult; D001253:Astrocytes / Q000378:metabolism / Q000473:pathology*; D015415:Biomarkers; D002574:Cervical Vertebrae / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007294:Inositol / Q000172:deficiency / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology; D009471:Neuromyelitis Optica / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology*; D013116:Spinal Cord / Q000378:metabolism / Q000473:pathology*
chemical_list: D015415:Biomarkers; D007294:Inositol