Longitudinally extensive spinal cord lesions: not always neuromyelitis optica

Objective: At present, studies on lymphocytes are mostly conducted on CD19+ B cells and CD27+ B cells in neuromyelitis optica spectrum disorders (NMOSDs), but the exact changes in lymphocyte subsets (CD19+ B cells, CD3+ T cells, CD4+ Th cells, CD8+ Ts cells, the CD4+/CD8+ ratio, and NK [CD56+ CD16] cells) have rarely been studied. This study aimed to assess lymphocyte subset changes in patients with NMOSD. Methods: We performed a cross-sectional study of consecutive patients with acute NMOSD (n = 41), chronic NMOSD (n = 21), and healthy individuals (n = 44). Peripheral blood samples were obtained upon admission, and lymphocyte subsets were analyzed by flow cytometry. Levels of lymphocyte subsets among 3 groups were compared and its correlation with the length of spinal cord lesions was analyzed. Results: The levels of peripheral blood CD19+ B cells were significantly higher in patients with acute and chronic NMOSD than in healthy controls (HCs) (17.91 ± 8.7%, 13.08 ± 7.562%, and 12.48 ± 3.575%, respectively; p < 0.001) and were positively correlated with the length of spinal cord lesions in acute NMOSD (r = 0.433, p < 0.05). The peripheral blood CD4+/CD8+ ratio was significantly lower in patients with acute NMOSD and chronic NMOSD than in HCs (1.497 ± 0.6387, 1.33 ± 0.5574, and 1.753 ± 0.659, respectively; p < 0.05), and the levels of peripheral blood NK (CD56+ CD16) cells were significantly lower in patients with acute and chronic NMOSD than in HCs (13.6 ± 10.13, 11.11 ± 7.057, and 14.7 [interquartile range = 9.28], respectively; p < 0.01). Conclusions: The levels of certain subsets of peripheral blood lymphocytes are associated with disease status in NMOSD.

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An acute onset of paraparesis in 65 years old Croatian woman – a case report

NATIONAL JOURNAL OF NEUROLOGY ◽

10.28942/nnj.v1i1(12).50 ◽

2018 ◽

Author(s):

V. Kosta

Keyword(s):

Spinal Cord ◽

Central Nervous System ◽

Nervous System ◽

Case Report ◽

Neuromyelitis Optica ◽

Demyelinating Disease ◽

Acute Onset ◽

Spinal Cord Lesions ◽

The Central Nervous System ◽

High Doses

Neuromyelitis optica (NMO, Devic`sdisease) is a rare inflammatory, demyelinating disease of the central nervous system that predominantly affects the spinal cord and optic nerves. Seropositivity for NMO-IgG (aquaporin 4antybodies) and longitudinally extensive spinal cord lesions (3 or more segments) are characteristics of NMO. We described a 65-year old woman with an acute onset of paraparesis that was not recognized as NMO at the beginning. The diagnosis was made three months later when she was readmitted because of the relapse.Despite the treatment with high doses of methylprednisolone, plasmapheresis and immunoglobulins her condition stayed unchanged – she was paraplegic and incontinent.

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Analysis of brain and spinal cord lesions to occult brain damage in seropositive and seronegative neuromyelitis optica

European Journal of Radiology ◽

10.1016/j.ejrad.2017.07.002 ◽

2017 ◽

Vol 94 ◽

pp. 25-30 ◽

Cited By ~ 1

Author(s):

Jie Sun ◽

Xianting Sun ◽

Ningnannan Zhang ◽

Qiuhui Wang ◽

Huanhuan Cai ◽

...

Keyword(s):

Spinal Cord ◽

Brain Damage ◽

Neuromyelitis Optica ◽

Spinal Cord Lesions ◽

Brain And Spinal Cord

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Characteristic linear lesions and longitudinally extensive spinal cord lesions in Chinese patients with neuromyelitis optica

Journal of the Neurological Sciences ◽

10.1016/j.jns.2010.02.026 ◽

2010 ◽

Vol 293 (1-2) ◽

pp. 92-96 ◽

Cited By ~ 20

Author(s):

Zhengqi Lu ◽

Wei Qiu ◽

Yan Zou ◽

Kefeng Lv ◽

Youming Long ◽

...

Keyword(s):

Spinal Cord ◽

Neuromyelitis Optica ◽

Chinese Patients ◽

Spinal Cord Lesions ◽

Linear Lesions

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Magnetic-Resonance Diffusion-Tensor Tractography in the Diagnosis of Tumefactive Spinal-Cord Lesions in Neuromyelitis Optica

Diagnostics ◽

10.3390/diagnostics10060401 ◽

2020 ◽

Vol 10 (6) ◽

pp. 401

Author(s):

Yung Hsu ◽

Ming-Chung Chou ◽

Poh-Shiow Yeh ◽

Te-Chang Wu ◽

Ching-Chung Ko ◽

...

Keyword(s):

Spinal Cord ◽

Magnetic Resonance ◽

Neuromyelitis Optica ◽

Diffusion Tensor ◽

Diffusion Tensor Tractography ◽

Spinal Cord Lesions ◽

Tissue Microstructure ◽

Aged Woman ◽

Middle Aged Woman ◽

Mr Diffusion

Magnetic-resonance (MR) imaging is the modality of choice for the evaluation of spinal-cord lesions. However, challenges persist in discriminating demyelinating processes from neoplastic lesions using conventional MR sequences. Consequently, an invasive spinal-cord biopsy is likely for most patients. MR diffusion-tensor imaging is an emerging noninvasive and powerful method for characterizing changes in tissue microstructure associated with spinal disorders. We currently present the case of a middle-aged woman suffering from neuromyelitis optica, and highlight that MR diffusion-tensor tractography can be helpful in the identification of tumefactive spinal-cord lesions.

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Spinal cord lesions in patients with neuromyelitis optica: a retrospective long-term MRI follow-up study

European Radiology ◽

10.1007/s00330-009-1425-3 ◽

2009 ◽

Vol 19 (10) ◽

pp. 2535-2543 ◽

Cited By ~ 62

Author(s):

Wolfgang Krampla ◽

Fahmy Aboul-Enein ◽

Julia Jecel ◽

Wilfried Lang ◽

Elisabeth Fertl ◽

...

Keyword(s):

Spinal Cord ◽

Neuromyelitis Optica ◽

Spinal Cord Lesions ◽

Follow Up Study

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Increased radial diffusivity in spinal cord lesions in neuromyelitis optica compared with multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458512436593 ◽

2012 ◽

Vol 18 (9) ◽

pp. 1259-1268 ◽

Cited By ~ 36

Author(s):

Eric C Klawiter ◽

Junqian Xu ◽

Robert T Naismith ◽

Tammie LS Benzinger ◽

Joshua S Shimony ◽

...

Keyword(s):

Multiple Sclerosis ◽

Spinal Cord ◽

Diffusion Tensor Imaging ◽

White Matter ◽

Neuromyelitis Optica ◽

Diffusion Tensor ◽

Healthy Controls ◽

Radial Diffusivity ◽

Spinal Cord Lesions ◽

T2 Lesions

Background: Multiple sclerosis (MS) and neuromyelitis optica (NMO) both affect spinal cord with notable differences in pathology. Objective: Determine the utility of diffusion tensor imaging (DTI) to differentiate the spinal cord lesions of NMO from MS within and outside T2 lesions. Methods: Subjects greater than or equal to 12 months from a clinical episode of transverse myelitis underwent a novel transaxial cervical spinal cord DTI sequence. Ten subjects with NMO, 10 with MS and 10 healthy controls were included. Results: Within T2 affected white matter regions, radial diffusivity was increased in both NMO and MS compared with healthy controls ( p<0.001, respectively), and to a greater extent in NMO than MS ( p<0.001). Axial diffusivity was decreased in T2 lesions in both NMO and MS compared with controls ( p<0.001, p=0.001), but did not differ between the two diseases. Radial diffusivity and fractional anisotropy within white matter regions upstream and downstream of T2 lesions were different from controls in each disease. Conclusions: Higher radial diffusivity within spinal cord white matter tracts derived from diffusion tensor imaging were appreciated in NMO compared with MS, consistent with the known greater tissue destruction seen in NMO. DTI also detected tissue alterations outside T2 lesions and may be a surrogate of anterograde and retrograde degeneration.

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