title: Neuromyelitis optica spectrum disorder and multiple sclerosis: Differentiation by a multimodal approach.
abstract: BACKGROUND
  Neuromyelitis optica spectrum disorder (NMOSD) differs from multiple sclerosis (MS) by prognosis and approach to treatment, and it is thus important to distinguish NMOSD from MS.
  
  
  OBJECTIVE
  We evaluated the structural brain abnormalities in patients with NMOSD and with relapsing-remitting MS (RRMS) using with MRI.
  
  
  METHODS
  Twenty-one NMOSD patients with antibodies against aquaporin 4, 32 patients with RRMS, and current age- and sex- matched 39 healthy subjects underwent 3-T MRI. The differences in gray matter volume and fractional anisotropy (FA) value among the three groups were evaluated.
  
  
  RESULTS
  There were significant global gray matter volume reductions of NMOSD and RRMS groups, compared to the healthy subjects. Significant and diffuse decreases in FA values were observed in both the NMOSD and RRMS patients. Significant gray matter volume and FA value reductions of the RRMS patients in the bilateral thalami and some regions were observed compared to the NMOSD patients.
  
  
  CONCLUSIONS
  Larger brain structural changes were seen in the RRMS group compared to the NMOSD group, and among them, the thalamus was revealed as the important region for the discrimination of these two diseases. MRI analyses of the brain may be helpful in differentiating NMOSD from RRMS patients.
authors.affiliation: Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan. Electronic address: ota@ncnp.go.jp.
authors.forename: Miho
authors.initials: M
authors.lastname: Ota
authors.affiliation: Department of Radiology, National Center of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Sato
authors.affiliation: Department of Neurology, National Center of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Okamoto
authors.affiliation: Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: Takamasa
authors.initials: T
authors.lastname: Noda
authors.affiliation: Department of Neurology, National Center of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Araki
authors.affiliation: Department of Immunology, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamamura
authors.affiliation: Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kunugi
mesh_terms: D016880:Anisotropy; D051401:Aquaporin 4 / Q000276:immunology; D001323:Autoantibodies / Q000378:metabolism; D001921:Brain / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D066128:Gray Matter / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology*; D009460:Neurologic Examination; D009471:Neuromyelitis Optica / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology*; D009929:Organ Size; D012720:Severity of Illness Index
chemical_list: C496030:AQP4 protein, human; D051401:Aquaporin 4; D001323:Autoantibodies
keywords: Aquaporin 4; Neuromyelitis optica spectrum disorder; Relapsing-remitting multiple sclerosis; Tract-based spatial statistics; Voxel-based morphometry