title: The role of cerebellar abnormalities in neuromyelitis optica--a comparison with multiple sclerosis and healthy controls.
abstract: BACKGROUND
  In relapsing-remitting multiple sclerosis (RRMS), the cerebellum is a known predilection site for atrophy. Neuromyelitis optica (NMO) is characterized by extensive lesions in the spinal cord and optic nerve; however, cerebellar involvement has been less studied. Secondary degeneration of the spinocerebellar tract could impact the cerebellum in NMO.
  
  
  OBJECTIVE
  We aimed to investigate whether spinal cord and cerebellar volume measures differ between patients with NMO and RRMS.
  
  
  METHODS
  Volumetric analyses of the cerebellum (TCV), the upper cervical cord (UCV) as well as the whole brain (NBV) of age- and gender-matched patients with NMO (n=30; 56% AQP4 +ve) and RRMS (n=25) were performed on 3T brain magnetic resonance imaging (MRI) and compared with 34 healthy controls (HC).
  
  
  RESULTS
  UCV was significantly reduced in NMO patients (6.3 cm(3)) as compared with HC (6.7 cm(3)), while patients with MS had reduced brain volumes compared with HC (NBV=1482 cm(3); p<0.001; TCV=188 cm(3); p=0.042), but UCV close to normal values. Patients with RRMS and NMO differed in NBV (p=0.001; lower in RRMS) and by trend (towards reduction in RRMS) in cerebellar volume (p=0.06).
  
  
  CONCLUSIONS
  While atrophy seems to be diffuse in MS patients, a rather focussed pattern with predominant involvement of the UCV was observed in NMO patients.
authors.affiliation: Department of Neurology, University Hospital Basel, Switzerland katrin.weier@usb.ch.
authors.forename: Katrin
authors.initials: K
authors.lastname: Weier
authors.affiliation: MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Arman
authors.initials: A
authors.lastname: Eshaghi
authors.affiliation: Department of Neurology, University Hospital Basel, Switzerland.
authors.forename: Stefano
authors.initials: S
authors.lastname: Magon
authors.affiliation: Department of Neurology, University Hospital Basel, Switzerland.
authors.forename: Michaela
authors.initials: M
authors.lastname: Andelova
authors.affiliation: Medical Image Analysis Center (MIAC) AG, c/o University Hospital Basel, Switzerland.
authors.forename: Ernst-Wilhelm
authors.initials: EW
authors.lastname: Radue
authors.affiliation: Department of Neurology, University Hospital Basel, Switzerland.
authors.forename: Ludwig
authors.initials: L
authors.lastname: Kappos
authors.affiliation: MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Amir Reza
authors.initials: AR
authors.lastname: Azimi
authors.affiliation: MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Sahraian
authors.affiliation: Department of Neurology, University Hospital Basel, Switzerland/Medical Image Analysis Center (MIAC) AG, c/o University Hospital Basel, Switzerland/Department of Radiology and Nuclear Medicine, Division of Neuroradiology, University Hospital Basel, Switzerland.
authors.forename: Till
authors.initials: T
authors.lastname: Sprenger
mesh_terms: D000328:Adult; D001284:Atrophy / Q000473:pathology; D001921:Brain / Q000473:pathology*; D002531:Cerebellum / Q000473:pathology*; D066193:Cervical Cord / Q000473:pathology*; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000473:pathology*; D009471:Neuromyelitis Optica / Q000473:pathology*; D055815:Young Adult
keywords: Neuromyelitis optica; cerebellum; magnetic resonance imaging; multiple sclerosis; spinal cord; volumetry