title: Hypothalamic abnormality in patients with inflammatory demyelinating disorders.
abstract: BACKGROUND
  Hypothalamic lesions in neuromyelitis optica (NMO) patients might be more specific for NMO than multiple sclerosis (MS). However, this is controversial.
  
  
  OBJECTIVE
  To characterize clinical features of patients with inflammatory demyelinating disorders (IDDs) with visible hypothalamic lesions using magnetic resonance imaging (MRI).
  
  
  METHODS
  Patients with IDDs (n = 429) were recruited retrospectively.
  
  
  RESULTS
  Of 52 patients with hypothalamic images enrolled, 42 were positive for aquaporin-4 (AQP4) antibodies, including 28 patients with NMO, 6 with recurrent transverse myelitis, 3 with recurrent optic neuritis, and 5 with brainstem and brain syndrome. The remaining 10 patients were anti-AQP4-negative, including 3 with MS, 3 with acute disseminated encephalomyelitis, and 4 with other disorders. In the AQP4-positive group, manifestations, including ataxia, intractable hiccup and nausea, syndrome of inappropriate antidiuretic hormone secretion and encephalopathy were more frequent in those with hypothalamic lesions than those without. Cell counts of cerebrospinal fluid in patients with hypothalamic lesions differed from patients without lesions. Brain MRI abnormalities were more frequent in brainstem and hemisphere of the hypothalamic lesion group.
  
  
  CONCLUSIONS
  Hypothalamic lesions were observed frequently in patients with AQP4 antibodies. Clinical manifestations and paraclinical features in AQP4-positive patients with hypothalamic lesions differed from those without lesions.
authors.affiliation: a 1 Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and The Ministry of Education of China , Institute of Neuroscience and the Second Affiliated Hospital of GuangZhou Medical University , Guangzhou , China.|b 2 Department of Neurology , the Second Affiliated Hospital of GuangZhou Medical University , Guangzhou , China.
authors.forename: Cong
authors.initials: C
authors.lastname: Gao
authors.affiliation: a 1 Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and The Ministry of Education of China , Institute of Neuroscience and the Second Affiliated Hospital of GuangZhou Medical University , Guangzhou , China.|b 2 Department of Neurology , the Second Affiliated Hospital of GuangZhou Medical University , Guangzhou , China.
authors.forename: Linzhan
authors.initials: L
authors.lastname: Wu
authors.affiliation: c 3 Department of Emergency , the Second Affiliated Hospital of GuangZhou Medical University , Guangzhou , China.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Chen
authors.affiliation: a 1 Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and The Ministry of Education of China , Institute of Neuroscience and the Second Affiliated Hospital of GuangZhou Medical University , Guangzhou , China.|b 2 Department of Neurology , the Second Affiliated Hospital of GuangZhou Medical University , Guangzhou , China.
authors.forename: Youming
authors.initials: Y
authors.lastname: Long
authors.affiliation: a 1 Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and The Ministry of Education of China , Institute of Neuroscience and the Second Affiliated Hospital of GuangZhou Medical University , Guangzhou , China.|b 2 Department of Neurology , the Second Affiliated Hospital of GuangZhou Medical University , Guangzhou , China.
authors.forename: Rong
authors.initials: R
authors.lastname: Zhong
authors.affiliation: d 4 Department of Neurology , the Fifth Affiliated Hospital of GuangZhou Medical University , Guangzhou , China.
authors.forename: Ning
authors.initials: N
authors.lastname: Yang
authors.affiliation: a 1 Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and The Ministry of Education of China , Institute of Neuroscience and the Second Affiliated Hospital of GuangZhou Medical University , Guangzhou , China.|b 2 Department of Neurology , the Second Affiliated Hospital of GuangZhou Medical University , Guangzhou , China.
authors.forename: Yaotang
authors.initials: Y
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D051401:Aquaporin 4 / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood / Q000134:cerebrospinal fluid; D001933:Brain Stem / Q000000981:diagnostic imaging*; D002648:Child; D020278:Demyelinating Autoimmune Diseases, CNS / Q000097:blood / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007031:Hypothalamus / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000097:blood / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging; D009188:Myelitis, Transverse / Q000097:blood / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging; D009471:Neuromyelitis Optica / Q000097:blood / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging; D009902:Optic Neuritis / Q000097:blood / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging; D055815:Young Adult
chemical_list: C496030:AQP4 protein, human; D051401:Aquaporin 4; D001323:Autoantibodies
keywords: aquaporin-4; hypothalamus; magnetic resonance imaging; neuromyelitis optica