title: Neuromyelitis optica shorter lesion can cause important pyramidal deficits.
abstract: OBJECTIVE
  Evaluate the correlation between spinal cord lesion length and pyramidal function system score in a cohort of patients with NMO.
  
  
  METHODS
  Retrospective retrieval of all exams performed in our center from January 2004 to December 2012 for patients with NMO. The exams were evaluated for lesion length, contrast enhancement and T1 hypointensity; these variables were correlated with the functional system score from the EDSS, performed no more than three months from the scan.
  
  
  RESULTS
  41 patients were included. Although patients with lesion extension ≥2 vertebral segments did not present worse pyramidal scores in a direct comparison, the influence of lesion length was not so strong when patients were separated in 3 groups (≥2, ≥3 or ≥4 vertebral segments) and evaluated with a receiving operating characteristics (ROC) curves. Gadolinium enhancement also contributed to more severe pyramidal system scores, but T1 hypointensity did not.
  
  
  CONCLUSIONS
  Although patients with spinal cord lesion extending ≥3 vertebral segments had more pyramidal disability, its difference was not so strong when compared to patients with ≥2 or ≥4 vertebral segments. This suggests that lesion extension might not be the most important factor in favoring a worse prognosis in spinal cord lesions in NMO.
authors.affiliation: Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Brazil. Electronic address: bichuetti@unifesp.br.
authors.forename: Denis Bernardi
authors.initials: DB
authors.lastname: Bichuetti
authors.affiliation: Department of Radiology, Universidade Federal de São Paulo, Brazil.
authors.forename: Marcelo Delboni
authors.initials: MD
authors.lastname: Lemos
authors.affiliation: Disciplina de Neurologia, Universidade Federal de São Paulo, Brazil.
authors.forename: Isac de
authors.initials: Id
authors.lastname: Castro
authors.affiliation: Department of Radiology, Universidade Federal de São Paulo, Brazil.
authors.forename: Gustavo Balthazar da Silveira
authors.initials: GB
authors.lastname: Carvalho
authors.affiliation: Department of Radiology, Universidade Federal de São Paulo, Brazil.
authors.forename: Renato Sartori de
authors.initials: RS
authors.lastname: Carvalho
authors.affiliation: Department of Radiology, Universidade Federal de São Paulo, Brazil.
authors.forename: Nitamar
authors.initials: N
authors.lastname: Abdala
authors.affiliation: Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Brazil.
authors.forename: Enedina Maria Lobato de
authors.initials: EM
authors.lastname: Oliveira
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000150:complications*; D011712:Pyramidal Tracts / Q000473:pathology*; D012372:ROC Curve; D013118:Spinal Cord Diseases / Q000175:diagnosis / Q000209:etiology*; D055815:Young Adult
chemical_list: D007074:Immunoglobulin G
keywords: Clinical correlation; Magnetic resonance imaging; Neuromyelitis optica; Prognosis; Pyramidal deficit; Short lesion