title: Brain lesion distribution criteria distinguish MS from AQP4-antibody NMOSD and MOG-antibody disease.
abstract: OBJECTIVE
  Neuromyelitis optica spectrum disorders (NMOSD) can present with very similar clinical features to multiple sclerosis (MS), but the international diagnostic imaging criteria for MS are not necessarily helpful in distinguishing these two diseases.
  
  
  OBJECTIVE
  This multicentre study tested previously reported criteria of '(1) at least 1 lesion adjacent to the body of the lateral ventricle and in the inferior temporal lobe; or (2) the presence of a subcortical U-fibre lesion or (3) a Dawson's finger-type lesion' in an independent cohort of relapsing-remitting multiple sclerosis (RRMS) and AQP4-ab NMOSD patients and also assessed their value in myelin oligodendrocyte glycoprotein (MOG)-ab positive and ab-negative NMOSD.
  
  
  METHODS
  Brain MRI scans were anonymised and scored on the criteria by 2 of 3 independent raters. In case of disagreement, the final opinion was made by the third rater.
  
  
  METHODS
  112 patients with NMOSD (31 AQP4-ab-positive, 21 MOG-ab-positive, 16 ab-negative) or MS (44) were selected from 3 centres (Oxford, Strasbourg and Liverpool) for the presence of brain lesions.
  
  
  RESULTS
  MRI brain lesion distribution criteria were able to distinguish RRMS with a sensitivity of 90.9% and with a specificity of 87.1% against AQP4-ab NMOSD, 95.2% against MOG-ab NMOSD and 87.5% in the heterogenous ab-negative NMOSD cohort. Over the whole NMOSD group, the specificity was 89.7%.
  
  
  CONCLUSIONS
  This study suggests that the brain MRI criteria for differentiating RRMS from NMOSD are sensitive and specific for all phenotypes.
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
authors.forename: Maciej
authors.initials: M
authors.lastname: Juryńczyk
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
authors.forename: George
authors.initials: G
authors.lastname: Tackley
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
authors.forename: Yazhuo
authors.initials: Y
authors.lastname: Kong
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
authors.forename: Ruth
authors.initials: R
authors.lastname: Geraldes
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
authors.forename: Lucy
authors.initials: L
authors.lastname: Matthews
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Woodhall
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
authors.forename: Patrick
authors.initials: P
authors.lastname: Waters
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Kuker
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Craner
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Weir
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
authors.forename: Gabriele C
authors.initials: GC
authors.lastname: DeLuca
authors.affiliation: ICube (UMR 7357, UdS, Centre National de la Recherche Scientifique), Fédération de médecine translationelle de Strasbourg, University de Strasbourg, Strasbourg, France.|Department of Radiology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors.forename: Stephane
authors.initials: S
authors.lastname: Kremer
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
authors.forename: Maria Isabel
authors.initials: MI
authors.lastname: Leite
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
authors.forename: Angela
authors.initials: A
authors.lastname: Vincent
authors.affiliation: NMO Clinical Service, The Walton Centre, Liverpool, UK.
authors.forename: Anu
authors.initials: A
authors.lastname: Jacob
authors.affiliation: Department of Neurology, University Hospital of Strasbourg, Strasbourg, France.|Fédération de médecine translationelle de Strasbourg, CIC 1434, University of Strasbourg, Strasbourg, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: de Sèze
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Palace
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D051401:Aquaporin 4 / Q000276:immunology; D001323:Autoantibodies / Q000276:immunology; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D063308:Myelin-Oligodendrocyte Glycoprotein / Q000276:immunology; D009471:Neuromyelitis Optica / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D051401:Aquaporin 4; D001323:Autoantibodies; D063308:Myelin-Oligodendrocyte Glycoprotein