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MRI patterns distinguish AQP4 antibody positive Neuromyelitis Optica Spectrum disorder from multiple sclerosis


Clarke, L and Arnett, S and Bukhari, W and Khalilidehkordi, E and Sanchez, S and OGorman, C and Sun, J and Prain, KM and Woodhall, M and Silvestrini, R and Bundell, CS and Abernethy, DA and Bhuta, S and Blum, S and Boundy, K and Brew, BJ and Brownlee, W and Butzkueven, H and Carroll, WM and Chen, C and Coulthard, A and Dale, RC and Das, C and Fabis-Pedrini, MJ and Gillis, D and Hawke, S and Heard, R and Henderson, APD and Heshmat, S and Hodgkinson, S and Kilpatrick, TJ and King, J and Kneebone, C and Kornberg, AJ and Lechner-Scott, J and Lin, MW and Lynch, C and Macdonell, RAL and Mason, DF and McCombe, PA and Pereira, J and Pollard, JD and Ramanathan, S and Reddel, SW and Shaw, CP and Spies, JM and Stankovich, J and Sutton, I and Vucic, S and Walsh, M and Wong, RC and Yiu, EM and Barnett, MH and Kermode, AGK and Marriott, MP and Parratt, JDE and Slee, M and Taylor, BVM and Willoughby, E and Brilot, F and Vincent, A and Waters, P and Broadley, SA and Sanchez, SJ and Boggild, M and Kornberg, AJ, MRI patterns distinguish AQP4 antibody positive Neuromyelitis Optica Spectrum disorder from multiple sclerosis, Frontiers in Neurology, 12 Article 722237. ISSN 1664-2295 (2021) [Refereed Article]

DOI: doi:10.3389/fneur.2021.722237


Neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) are inflammatory diseases of the CNS. Overlap in the clinical and MRI features of NMOSD and MS means that distinguishing these conditions can be difficult. With the aim of evaluating the diagnostic utility of MRI features in distinguishing NMOSD from MS, we have conducted a cross-sectional analysis of imaging data and developed predictive models to distinguish the two conditions. NMOSD and MS MRI lesions were identified and defined through a literature search. Aquaporin-4 (AQP4) antibody positive NMOSD cases and age- and sex-matched MS cases were collected. MRI of orbits, brain and spine were reported by at least two blinded reviewers. MRI brain or spine was available for 166/168 (99%) of cases. Longitudinally extensive (OR = 203), "bright spotty" (OR = 93.8), whole (axial; OR = 57.8) or gadolinium (Gd) enhancing (OR = 28.6) spinal cord lesions, bilateral (OR = 31.3) or Gd-enhancing (OR = 15.4) optic nerve lesions, and nucleus tractus solitarius (OR = 19.2), periaqueductal (OR = 16.8) or hypothalamic (OR = 7.2) brain lesions were associated with NMOSD. Ovoid (OR = 0.029), Dawson's fingers (OR = 0.031), pyramidal corpus callosum (OR = 0.058), periventricular (OR = 0.136), temporal lobe (OR = 0.137) and T1 black holes (OR = 0.154) brain lesions were associated with MS. A score-based algorithm and a decision tree determined by machine learning accurately predicted more than 85% of both diagnoses using first available imaging alone. We have confirmed NMOSD and MS specific MRI features and combined these in predictive models that can accurately identify more than 85% of cases as either AQP4 seropositive NMOSD or MS.

Item Details

Item Type:Refereed Article
Keywords:neuromyelitis optica, multiple sclerosis, magnetic resonance imaging, diagnosis, NMOSD
Research Division:Biomedical and Clinical Sciences
Research Group:Neurosciences
Research Field:Neurology and neuromuscular diseases
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Stankovich, J (Dr Jim Stankovich)
UTAS Author:Taylor, BVM (Professor Bruce Taylor)
ID Code:152697
Year Published:2021
Web of Science® Times Cited:2
Deposited By:Menzies Institute for Medical Research
Deposited On:2022-08-23
Last Modified:2022-08-29

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