title: Brain parenchymal damage in neuromyelitis optica spectrum disorder - A multimodal MRI study.
abstract: OBJECTIVE
  To investigate different brain regions for grey (GM) and white matter (WM) damage in a well-defined cohort of neuromyelitis optica spectrum disorder (NMOSD) patients and compare advanced MRI techniques (VBM, Subcortical and cortical analyses (Freesurfer), and DTI) for their ability to detect damage in NMOSD.
  
  
  METHODS
  We analyzed 21 NMOSD patients and 21 age and gender matched control subjects. VBM (GW/WM) and DTI whole brain (TBSS) analyses were performed at different statistical thresholds to reflect different statistical approaches in previous studies. In an automated atlas-based approach, Freesurfer and DTI results were compared between NMOSD and controls.
  
  
  RESULTS
  DTI TBSS and DTI atlas based analysis demonstrated microstructural impairment only within the optic radiation or in regions associated with the optic radiation (posterior thalamic radiation p < 0.001, 6.9 % reduction of fractional anisotropy). VBM demonstrated widespread brain GM and WM reduction, but only at exploratory statistical thresholds, with no differences remaining after correction for multiple comparisons. Freesurfer analysis demonstrated no group differences.
  
  
  CONCLUSIONS
  NMOSD specific parenchymal brain damage is predominantly located in the optic radiation, likely due to a secondary degeneration caused by ON. In comparison, DTI appears to be the most reliable and sensitive technique for brain damage detection in NMOSD.
  
  
  CONCLUSIONS
  • The hypothesis of a widespread brain damage in NMOSD is challenged. • The optic radiation (OR) is the most severely affected region. • OR-affection is likely due to secondary degeneration following optic neuritis. • DTI is currently the most sensitive technique for NMOSD-related brain-damage detection. • DTI is currently the most reliable technique for NMOSD-related brain-damage detection.
authors.affiliation: NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité- Universitätsmedizin Berlin, Berlin, Germany. florence.pache@charite.de.|Department of Neurology, Charité- Universitätsmedizin Berlin, Berlin, Germany. florence.pache@charite.de.
authors.forename: F
authors.identifier: http://orcid.org/0000-0003-2513-0664
authors.initials: F
authors.lastname: Pache
authors.affiliation: NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité- Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Zimmermann
authors.affiliation: Department of Neurology, Charité- Universitätsmedizin Berlin, Berlin, Germany.|Berlin School of Mind and Brain, Humboldt-Universitaet zu Berlin, Berlin, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Finke
authors.affiliation: NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité- Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Lacheta
authors.affiliation: NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité- Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Papazoglou
authors.affiliation: NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité- Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Kuchling
authors.affiliation: NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité- Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Wuerfel
authors.affiliation: Department of Radiology, Charité- Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Hamm
authors.affiliation: Department of Neurology, Charité- Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Ruprecht
authors.affiliation: NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité- Universitätsmedizin Berlin, Berlin, Germany.|Department of Neurology, Charité- Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Paul
authors.affiliation: NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité- Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: A U
authors.initials: AU
authors.lastname: Brandt
authors.affiliation: NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité- Universitätsmedizin Berlin, Berlin, Germany.|Department of Radiology, Charité- Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Scheel
mesh_terms: D000328:Adult; D016880:Anisotropy; D001921:Brain / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D056324:Diffusion Tensor Imaging; D005260:Female; D066128:Gray Matter / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009471:Neuromyelitis Optica / Q000000981:diagnostic imaging*; D009900:Optic Nerve / Q000000981:diagnostic imaging*; D041623:Tomography, Optical Coherence; D066127:White Matter / Q000000981:diagnostic imaging*
keywords: Demyelination; Diffusion tensor Imaging; Neuromyelitis optica spectrum disorder; Optical coherence tomography; VBM analysis