PACTRIMS 2019

Abstract

Background: Brain MRI abnormalities are common in patients with neuromyelitis optica spectrum disorders (NMOSD). However, dedicated MRI research particularly in a large multicenter cohort that focuses on lesion characteristics, especially in Chinese NMOSD is lacking, and the associations between the MRI characteristics and clinical outcomes remain unknown. Objective: To investigate the brain MRI features in NMOSD and its clinical relevance in a large multi-center cohort in China. Methods: 270 NMOSD patients were recruited from seven centers. The brain MRI were classified as normal, NMOSD-specific lesions, multiple sclerosis-like, nonspecific white matter changes. Brain volumes were measured. The relationship between MRI measures, clinical disability and cognitive impairment were investigated. Results: 98 patients (36.3%) had normal brain MRI; 48 patients (17.7%) had NMOSD-specific lesions located in dorsal brainstem, corticospinal tract corpus, callosum and periependymal lesions surrounding the ventricular system; 16 patients (6%) had multiple sclerosis-like lesions; and 108 patients (40%) had nonspecific white matter changes. NMOSD patients with brain lesions had a trend of smaller subcortex grey matter volume compared to patients without lesions. 52.5% patients with normal brain MRI and 50.8% patients with abnormal brain MRI showed cognitiveimpairment. No significant differences were identified in brain volume between cognitive impairment and cognitive preserved groups. Conclusion: In this large multi-center NMOSD cohort, nonspecific white matter changes were the most common findings (40%). NMOSD patients with brain lesions demonstrated a trend of more brain atrophy than patients without lesions. Approximately 50% NMOSD patients presented cognitive impairment independent of brain lesions.