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Clarke L, Arnett S, Bukhari W, et al. MRI Patterns Distinguish AQP4 Antibody Positive Neuromyelitis Optica Spectrum Disorder From Multiple Sclerosis. Front Neurol. 2021;12:722237doi: 10.3389/fneur.2021.722237.
Clarke, L., Arnett, S., Bukhari, W., Khalilidehkordi, E., Jimenez Sanchez, S., O'Gorman, C., Sun, J., Prain, K. M., Woodhall, M., Silvestrini, R., Bundell, C. S., Abernethy, D. A., Bhuta, S., Blum, S., Boggild, M., Boundy, K., Brew, B. J., Brownlee, W., Butzkueven, H., Carroll, W. M., Chen, C., Coulthard, A., Dale, R. C., Das, C., Fabis-Pedrini, M. J., Gillis, D., Hawke, S., Heard, R., Henderson, A. P. D., Heshmat, S., Hodgkinson, S., Kilpatrick, T. J., King, J., Kneebone, C., Kornberg, A. J., Lechner-Scott, J., Lin, M. W., Lynch, C., Macdonell, R. A. L., Mason, D. F., McCombe, P. A., Pereira, J., Pollard, J. D., Ramanathan, S., Reddel, S. W., Shaw, C. P., Spies, J. M., Stankovich, J., Sutton, I., Vucic, S., Walsh, M., Wong, R. C., Yiu, E. M., Barnett, M. H., Kermode, A. G. K., Marriott, M. P., Parratt, J. D. E., Slee, M., Taylor, B. V., Willoughby, E., Brilot, F., Vincent, A., Waters, P., & Broadley, S. A. (2021). MRI Patterns Distinguish AQP4 Antibody Positive Neuromyelitis Optica Spectrum Disorder From Multiple Sclerosis. Frontiers in neurology, 12722237. https://doi.org/10.3389/fneur.2021.722237
Clarke, Laura, et al. "MRI Patterns Distinguish AQP4 Antibody Positive Neuromyelitis Optica Spectrum Disorder From Multiple Sclerosis." Frontiers in neurology vol. 12 (2021): 722237. doi: https://doi.org/10.3389/fneur.2021.722237
Clarke L, Arnett S, Bukhari W, Khalilidehkordi E, Jimenez Sanchez S, O'Gorman C, Sun J, Prain KM, Woodhall M, Silvestrini R, Bundell CS, Abernethy DA, Bhuta S, Blum S, Boggild M, Boundy K, Brew BJ, Brownlee W, Butzkueven H, Carroll WM, Chen C, Coulthard A, Dale RC, Das C, Fabis-Pedrini MJ, Gillis D, Hawke S, Heard R, Henderson APD, Heshmat S, Hodgkinson S, Kilpatrick TJ, King J, Kneebone C, Kornberg AJ, Lechner-Scott J, Lin MW, Lynch C, Macdonell RAL, Mason DF, McCombe PA, Pereira J, Pollard JD, Ramanathan S, Reddel SW, Shaw CP, Spies JM, Stankovich J, Sutton I, Vucic S, Walsh M, Wong RC, Yiu EM, Barnett MH, Kermode AGK, Marriott MP, Parratt JDE, Slee M, Taylor BV, Willoughby E, Brilot F, Vincent A, Waters P, Broadley SA. MRI Patterns Distinguish AQP4 Antibody Positive Neuromyelitis Optica Spectrum Disorder From Multiple Sclerosis. Front Neurol. 2021 Sep 09;12:722237. doi: 10.3389/fneur.2021.722237. eCollection 2021. PMID: 34566866; PMCID: PMC8458658.
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Front Neurol. 2021 Sep 09;12:722237. doi: 10.3389/fneur.2021.722237. eCollection 2021.

MRI Patterns Distinguish AQP4 Antibody Positive Neuromyelitis Optica Spectrum Disorder From Multiple Sclerosis.

Frontiers in neurology

Laura Clarke, Simon Arnett, Wajih Bukhari, Elham Khalilidehkordi, Sofia Jimenez Sanchez, Cullen O'Gorman, Jing Sun, Kerri M Prain, Mark Woodhall, Roger Silvestrini, Christine S Bundell, David A Abernethy, Sandeep Bhuta, Stefan Blum, Mike Boggild, Karyn Boundy, Bruce J Brew, Wallace Brownlee, Helmut Butzkueven, William M Carroll, Cella Chen, Alan Coulthard, Russell C Dale, Chandi Das, Marzena J Fabis-Pedrini, David Gillis, Simon Hawke, Robert Heard, Andrew P D Henderson, Saman Heshmat, Suzanne Hodgkinson, Trevor J Kilpatrick, John King, Christopher Kneebone, Andrew J Kornberg, Jeannette Lechner-Scott, Ming-Wei Lin, Christopher Lynch, Richard A L Macdonell, Deborah F Mason, Pamela A McCombe, Jennifer Pereira, John D Pollard, Sudarshini Ramanathan, Stephen W Reddel, Cameron P Shaw, Judith M Spies, James Stankovich, Ian Sutton, Steve Vucic, Michael Walsh, Richard C Wong, Eppie M Yiu, Michael H Barnett, Allan G K Kermode, Mark P Marriott, John D E Parratt, Mark Slee, Bruce V Taylor, Ernest Willoughby, Fabienne Brilot, Angela Vincent, Patrick Waters, Simon A Broadley

Affiliations

  1. Menzies Health Institute Queensland, Gold Coast, Griffith University, Southport, QLD, Australia.
  2. Department of Immunology, Pathology Queensland, Royal Brisbane and Women's Hospital, Herston, QLD, Australia.
  3. Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom.
  4. Department of Immunopathology, Westmead Hospital, Westmead, NSW, Australia.
  5. School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, WA, Australia.
  6. Department of Neurology, Wellington Hospital, Newtown, New Zealand.
  7. Department of Neurology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia.
  8. Department of Neurology, Townsville Hospital, Douglas, QLD, Australia.
  9. Department of Neurology, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia.
  10. Centre for Applied Medical Research, St. Vincent's Hospital, University of New South Wales, Darlinghurst, NSW, Australia.
  11. Department of Neurology, Auckland City Hospital, Grafton, New Zealand.
  12. Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia.
  13. Centre for Neuromuscular and Neurological Disorders, Queen Elizabeth II Medical Centre, Perron Institute for Neurological and Translational Science, University of Western Australia, Nedlands, WA, Australia.
  14. Department of Ophthalmology, Flinders Medical Centre, Flinders University, Bedford Park, SA, Australia.
  15. School of Medicine, Royal Brisbane and Women's Hospital, University of Queensland, Herston, QLD, Australia.
  16. Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia.
  17. Department of Neurology, Canberra Hospital, Garran, ACT, Australia.
  18. Sydney Medical School, Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW, Australia.
  19. Department of Neurology, Westmead Hospital, Westmead, NSW, Australia.
  20. South Western Sydney Medical School, Liverpool Hospital, University of New South Wales, Liverpool, NSW, Australia.
  21. Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia.
  22. Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, Australia.
  23. Department of Neurology, Royal Adelaide Hospital, Adelaide, SA, Australia.
  24. School of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia.
  25. Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia.
  26. School of Medicine, University of Auckland, Grafton, New Zealand.
  27. Department of Neurology, Austin Health, Heidelberg, VIC, Australia.
  28. Department of Neurology, Christchurch Hospital, Christchurch, New Zealand.
  29. Centre for Clinical Research, Royal Brisbane and Women's Hospital, University of Queensland, Herston, QLD, Australia.
  30. Neuroimmunology Group, Kids Neurosciences Centre, Children's Hospital at Westmead, University of Sydney, Westmead, NSW, Australia.
  31. Department of Neurology, Concord Repatriation General Hospital, Concord, NSW, Australia.
  32. School of Medicine, Deakin University, Waurn Ponds, VIC, Australia.
  33. Menzies Research Institute, University of Tasmania, Hobart, TAS, Australia.
  34. Department of Neurology, St. Vincent's Hospital, Darlinghurst, NSW, Australia.
  35. Department of Neurology, Gold Coast University Hospital, Southport, QLD, Australia.

PMID: 34566866 PMCID: PMC8458658 DOI: 10.3389/fneur.2021.722237

Abstract

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.

Copyright © 2021 Clarke, Arnett, Bukhari, Khalilidehkordi, Jimenez Sanchez, O'Gorman, Sun, Prain, Woodhall, Silvestrini, Bundell, Abernethy, Bhuta, Blum, Boggild, Boundy, Brew, Brownlee, Butzkueven, Carroll, Chen, Coulthard, Dale, Das, Fabis-Pedrini, Gillis, Hawke, Heard, Henderson, Heshmat, Hodgkinson, Kilpatrick, King, Kneebone, Kornberg, Lechner-Scott, Lin, Lynch, Macdonell, Mason, McCombe, Pereira, Pollard, Ramanathan, Reddel, Shaw, Spies, Stankovich, Sutton, Vucic, Walsh, Wong, Yiu, Barnett, Kermode, Marriott, Parratt, Slee, Taylor, Willoughby, Brilot, Vincent, Waters and Broadley.

Keywords: NMOSD; diagnosis; magnetic resonance imaging; multiple sclerosis; neuromyelitis optica

Conflict of interest statement

MHB has received research support, speaking engagement honoraria, advisory board honoraria and travel sponsorship from Biogen Idec, Merck, Novartis, Roche and Sanofi-Genzyme, and is a consulting neuro

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