title: Linear lesions may assist early diagnosis of neuromyelitis optica and longitudinally extensive transverse myelitis, two subtypes of NMOSD.
abstract: OBJECTIVE
  To investigate the relationship between linear lesions (LL) and the development of longitudinally extensive spinal cord lesions (LESCL) in Chinese patients with neuromyelitis optica or longitudinally extensive transverse myelitis.
  
  
  METHODS
  The clinical records of 143 patients with these conditions were reviewed. Forty-one patients with LL were divided into three groups according to the order of appearance of LL and LESCL (simultaneously [n=10], LL first [n=26], or LESCL first [n=5]). The remaining 102 patients without LL were used as a control group.
  
  
  RESULTS
  Patients who developed LL first demonstrated a lower annualized relapse rate than those in the simultaneous group (1.00 [0.23-10.00] vs. 4.38 [0.60-6.67], p=0.017) and the control group (1.00 [0.23-10.00] vs. 2.00 [0.24-10.00], p=0.007). Among all patients with LL, there were significantly more who developed them before LESCL than those who developed them after LESCL (p<0.001) or at the same time (p=0.008). The mean time before the appearance of LESCL was 9.0months (2-35months) in the 'LL-first' group, which was shorter than that in the control group (12months [1-60months], p=0.010). The rate of positivity for anti-aquaporin 4 IgG antibodies was higher in patients with LL compared with controls (90.24% vs. 64.71%, p=0.002).
  
  
  CONCLUSIONS
  LL may be a precursor to LESCL and assist early diagnosis of neuromyelitis optica and longitudinally extensive transverse myelitis.
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Cai
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, People's Republic of China.
authors.forename: Sha
authors.initials: S
authors.lastname: Tan
authors.affiliation: Department of Neurology, The Fifth Affiliated Hospital of Sun Yat-sen University, People's Republic of China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, People's Republic of China.
authors.forename: Yilong
authors.initials: Y
authors.lastname: Shan
authors.affiliation: Department of Neurology, The Affiliated Hospital of Wei Fang Medical University, People's Republic of China.
authors.forename: Yanqiang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, People's Republic of China.
authors.forename: Yinyao
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Sun Yat-sen University, People's Republic of China.
authors.forename: Fangjing
authors.initials: F
authors.lastname: Zhou
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, People's Republic of China.
authors.forename: Bingjun
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, People's Republic of China.
authors.forename: Xiaoyu
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, People's Republic of China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, People's Republic of China.
authors.forename: Yuge
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, People's Republic of China.
authors.forename: Xuehong
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, People's Republic of China.
authors.forename: Xuejiao
authors.initials: X
authors.lastname: Men
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, People's Republic of China.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Qiu
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, People's Republic of China.
authors.forename: Xueqiang
authors.initials: X
authors.lastname: Hu
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, People's Republic of China. Electronic address: lzq1828@163.com.
authors.forename: Zhengqi
authors.initials: Z
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D051401:Aquaporin 4 / Q000276:immunology; D001323:Autoantibodies; D001921:Brain / Q000473:pathology*; D002648:Child; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009188:Myelitis, Transverse / Q000276:immunology / Q000473:pathology*; D009471:Neuromyelitis Optica / Q000276:immunology / Q000473:pathology*; D013116:Spinal Cord / Q000473:pathology*; D055815:Young Adult
chemical_list: D051401:Aquaporin 4; D001323:Autoantibodies
keywords: Linear lesion; Longitudinally extensive spinal cord lesion; Longitudinally extensive transverse myelitis; Neuromyelitis optica; Neuromyelitis optica spectrum disorder