Frontiers in Neurology (Sep 2021)
MRI Patterns Distinguish AQP4 Antibody Positive Neuromyelitis Optica Spectrum Disorder From Multiple Sclerosis
- 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,
- 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,
- Fabienne Brilot,
- Angela Vincent,
- Patrick Waters,
- Simon A. Broadley,
- Simon A. Broadley
Affiliations
- Laura Clarke
- Menzies Health Institute Queensland, Gold Coast, Griffith University, Southport, QLD, Australia
- Simon Arnett
- Menzies Health Institute Queensland, Gold Coast, Griffith University, Southport, QLD, Australia
- Wajih Bukhari
- Menzies Health Institute Queensland, Gold Coast, Griffith University, Southport, QLD, Australia
- Elham Khalilidehkordi
- Menzies Health Institute Queensland, Gold Coast, Griffith University, Southport, QLD, Australia
- Sofia Jimenez Sanchez
- Menzies Health Institute Queensland, Gold Coast, Griffith University, Southport, QLD, Australia
- Cullen O'Gorman
- Menzies Health Institute Queensland, Gold Coast, Griffith University, Southport, QLD, Australia
- Jing Sun
- Menzies Health Institute Queensland, Gold Coast, Griffith University, Southport, QLD, Australia
- Kerri M. Prain
- Department of Immunology, Pathology Queensland, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
- Mark Woodhall
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
- Roger Silvestrini
- Department of Immunopathology, Westmead Hospital, Westmead, NSW, Australia
- Christine S. Bundell
- School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, WA, Australia
- David A. Abernethy
- Department of Neurology, Wellington Hospital, Newtown, New Zealand
- Sandeep Bhuta
- Menzies Health Institute Queensland, Gold Coast, Griffith University, Southport, QLD, Australia
- Stefan Blum
- Department of Neurology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
- Mike Boggild
- Department of Neurology, Townsville Hospital, Douglas, QLD, Australia
- Karyn Boundy
- Department of Neurology, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
- Bruce J. Brew
- 0Centre for Applied Medical Research, St. Vincent's Hospital, University of New South Wales, Darlinghurst, NSW, Australia
- Wallace Brownlee
- 1Department of Neurology, Auckland City Hospital, Grafton, New Zealand
- Helmut Butzkueven
- 2Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia
- William M. Carroll
- 3Centre for Neuromuscular and Neurological Disorders, Queen Elizabeth II Medical Centre, Perron Institute for Neurological and Translational Science, University of Western Australia, Nedlands, WA, Australia
- Cella Chen
- 4Department of Ophthalmology, Flinders Medical Centre, Flinders University, Bedford Park, SA, Australia
- Alan Coulthard
- 5School of Medicine, Royal Brisbane and Women's Hospital, University of Queensland, Herston, QLD, Australia
- Russell C. Dale
- 6Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
- Chandi Das
- 7Department of Neurology, Canberra Hospital, Garran, ACT, Australia
- Marzena J. Fabis-Pedrini
- 3Centre for Neuromuscular and Neurological Disorders, Queen Elizabeth II Medical Centre, Perron Institute for Neurological and Translational Science, University of Western Australia, Nedlands, WA, Australia
- David Gillis
- 5School of Medicine, Royal Brisbane and Women's Hospital, University of Queensland, Herston, QLD, Australia
- Simon Hawke
- 8Sydney Medical School, Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW, Australia
- Robert Heard
- 6Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
- Andrew P. D. Henderson
- 9Department of Neurology, Westmead Hospital, Westmead, NSW, Australia
- Saman Heshmat
- Menzies Health Institute Queensland, Gold Coast, Griffith University, Southport, QLD, Australia
- Suzanne Hodgkinson
- 0South Western Sydney Medical School, Liverpool Hospital, University of New South Wales, Liverpool, NSW, Australia
- Trevor J. Kilpatrick
- 1Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
- John King
- 2Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, Australia
- Christopher Kneebone
- 3Department of Neurology, Royal Adelaide Hospital, Adelaide, SA, Australia
- Andrew J. Kornberg
- 4School of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
- Jeannette Lechner-Scott
- 5Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
- Ming-Wei Lin
- 8Sydney Medical School, Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW, Australia
- Christopher Lynch
- 6School of Medicine, University of Auckland, Grafton, New Zealand
- Richard A. L. Macdonell
- 7Department of Neurology, Austin Health, Heidelberg, VIC, Australia
- Deborah F. Mason
- 8Department of Neurology, Christchurch Hospital, Christchurch, New Zealand
- Pamela A. McCombe
- 9Centre for Clinical Research, Royal Brisbane and Women's Hospital, University of Queensland, Herston, QLD, Australia
- Jennifer Pereira
- 6School of Medicine, University of Auckland, Grafton, New Zealand
- John D. Pollard
- 8Sydney Medical School, Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW, Australia
- Sudarshini Ramanathan
- 0Neuroimmunology Group, Kids Neurosciences Centre, Children's Hospital at Westmead, University of Sydney, Westmead, NSW, Australia
- Sudarshini Ramanathan
- 1Department of Neurology, Concord Repatriation General Hospital, Concord, NSW, Australia
- Stephen W. Reddel
- 6Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
- Cameron P. Shaw
- 2School of Medicine, Deakin University, Waurn Ponds, VIC, Australia
- Judith M. Spies
- 8Sydney Medical School, Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW, Australia
- James Stankovich
- 3Menzies Research Institute, University of Tasmania, Hobart, TAS, Australia
- Ian Sutton
- 4Department of Neurology, St. Vincent's Hospital, Darlinghurst, NSW, Australia
- Steve Vucic
- 9Department of Neurology, Westmead Hospital, Westmead, NSW, Australia
- Michael Walsh
- Department of Neurology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
- Richard C. Wong
- 5School of Medicine, Royal Brisbane and Women's Hospital, University of Queensland, Herston, QLD, Australia
- Eppie M. Yiu
- 4School of Paediatrics, Royal Children's Hospital, University of Melbourne, Parkville, VIC, Australia
- Michael H. Barnett
- 6Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
- Allan G. K. Kermode
- 3Centre for Neuromuscular and Neurological Disorders, Queen Elizabeth II Medical Centre, Perron Institute for Neurological and Translational Science, University of Western Australia, Nedlands, WA, Australia
- Mark P. Marriott
- 2Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia
- John D. E. Parratt
- 8Sydney Medical School, Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW, Australia
- Mark Slee
- Department of Neurology, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
- Bruce V. Taylor
- 3Menzies Research Institute, University of Tasmania, Hobart, TAS, Australia
- Ernest Willoughby
- 1Department of Neurology, Auckland City Hospital, Grafton, New Zealand
- Fabienne Brilot
- 6Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
- Fabienne Brilot
- 0Neuroimmunology Group, Kids Neurosciences Centre, Children's Hospital at Westmead, University of Sydney, Westmead, NSW, Australia
- Angela Vincent
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
- Patrick Waters
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
- Simon A. Broadley
- Menzies Health Institute Queensland, Gold Coast, Griffith University, Southport, QLD, Australia
- Simon A. Broadley
- 5Department of Neurology, Gold Coast University Hospital, Southport, QLD, Australia
- DOI
- https://doi.org/10.3389/fneur.2021.722237
- Journal volume & issue
-
Vol. 12
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.
Keywords
