title: Comparison of clinical characteristics between neuromyelitis optica spectrum disorders with and without spinal cord atrophy.
abstract: BACKGROUND
  Spinal cord lesions is one of the predominant characteristics in patients with neuromyelitis optica spectrum disorders (NMOSD). Interestingly, mounting evidence indicates that spinal cord atrophy (SCA) is one of common clinical features in multiple sclerosis (MS) patients, and correlates closely with the neurological disability. However, Clinical studies related to the SCA aspects of NMOSD are still scarce.
  
  
  METHODS
  We retrospectively analyzed 185 patients with NMOSD, including 23 patients with SCA and 162 patients without SCA. Data were collected regarding clinical characteristics, laboratory tests, and magnetic resonance imaging findings.
  
  
  RESULTS
  12.4% of patients had SCA in NMOSD. Patients with SCA had a longer disease duration and higher EDSS at clinical onset and last visit. More importantly, SCA patients were more prone to reach disability milestones (EDSS ≥ 6.0). Bowel or bladder dysfunction, movement disorders, and sensory disturbances symptoms were more common in patients with SCA. ESR and CRP were significantly higher in patients with SCA than those without SCA. Patients with SCA were more frequently complicated with cervical cord lesions. However, the ARR, progression index, seropositive rate of NMO-IgG and OCB were similar in the two groups. Futhermore, LETM did not differ significantly between patients with SCA and without SCA in NMOSD patients.
  
  
  CONCLUSIONS
  Patients with SCA might have longer disease duration, more severe clinical disability, and more frequently complicated with cervical spinal cord lesions. SCA might be predictive of the more severe neurologic dysfunction and worse prognosis in NMOSD. Inflammation contributes to the development of SCA in NMOSD.
authors.affiliation: Multiple Sclerosis Center, Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, No 600 Tianhe Road, Guangzhou, Guangdong, 510630, China. wangqiangdoctor@126.com.
authors.forename: Yanqiang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Multiple Sclerosis Center, Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, No 600 Tianhe Road, Guangzhou, Guangdong, 510630, China. w@163.com.
authors.forename: Aimin
authors.initials: A
authors.lastname: Wu
authors.affiliation: Multiple Sclerosis Center, Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, No 600 Tianhe Road, Guangzhou, Guangdong, 510630, China. chen@163.com.
authors.forename: Xiaoyu
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Neurology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China. zhang@163.com.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Multiple Sclerosis Center, Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, No 600 Tianhe Road, Guangzhou, Guangdong, 510630, China. lin@163.com.
authors.forename: Yinyao
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Multiple Sclerosis Center, Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, No 600 Tianhe Road, Guangzhou, Guangdong, 510630, China. shaoyang@163.com.
authors.forename: Shaoyang
authors.initials: S
authors.lastname: Sun
authors.affiliation: Multiple Sclerosis Center, Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, No 600 Tianhe Road, Guangzhou, Guangdong, 510630, China. wei@163.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Cai
authors.affiliation: Multiple Sclerosis Center, Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, No 600 Tianhe Road, Guangzhou, Guangdong, 510630, China. Zhangg@126.com.
authors.forename: Bingjun
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. zhuang@163.com.
authors.forename: Zhuang
authors.initials: Z
authors.lastname: Kang
authors.affiliation: Multiple Sclerosis Center, Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, No 600 Tianhe Road, Guangzhou, Guangdong, 510630, China. qiug@126.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Qiu
authors.affiliation: Multiple Sclerosis Center, Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, No 600 Tianhe Road, Guangzhou, Guangdong, 510630, China. huxue@163.com.
authors.forename: Xueqiang
authors.initials: X
authors.lastname: Hu
authors.affiliation: Multiple Sclerosis Center, Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, No 600 Tianhe Road, Guangzhou, Guangdong, 510630, China. luzhqidoctor@126.com.
authors.forename: Zhengqi
authors.initials: Z
authors.lastname: Lu
mesh_terms: D000328:Adult; D051401:Aquaporin 4 / Q000276:immunology; D001284:Atrophy / Q000150:complications; D001323:Autoantibodies / Q000276:immunology; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000276:immunology; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology*; D009103:Multiple Sclerosis / Q000473:pathology; D009471:Neuromyelitis Optica / Q000134:cerebrospinal fluid / Q000150:complications* / Q000276:immunology; D043025:Oligoclonal Bands / Q000134:cerebrospinal fluid; D012189:Retrospective Studies; D012678:Sensation Disorders / Q000209:etiology*; D013116:Spinal Cord / Q000473:pathology*; D013118:Spinal Cord Diseases / Q000134:cerebrospinal fluid / Q000150:complications* / Q000276:immunology / Q000473:pathology; D013997:Time Factors; D001745:Urinary Bladder Diseases / Q000209:etiology*
chemical_list: C496030:AQP4 protein, human; D051401:Aquaporin 4; D001323:Autoantibodies; D043025:Oligoclonal Bands; D002097:C-Reactive Protein