Centrally-located transverse myelitis would facilitate the differentiation of NMOSD and MOG-AD from MS

(2022) Centrally-located transverse myelitis would facilitate the differentiation of NMOSD and MOG-AD from MS. MULTIPLE SCLEROSIS AND RELATED DISORDERS. ISSN 2211-0348 2211-0356 J9 - MULT SCLER RELAT DIS

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Abstract

Objectives: Differentiating neuromyelitis optica spectrum disorder (NMOSD) and Myelin oligodendrocyte glycoprotein antibody disease (MOG-AD) from multiple sclerosis (MS) is important since MS therapies might result in progression and relapse of the former diseases. Evidence of long extending transverse myelitis (LETM) in magnetic resonance imaging (MRI) is one of the requirements to make an NMOSD diagnosis. However, centrally located lesions on spinal MRI may bring higher sensitivity and specificity to the NMOSD and MOG-AD diagnosis. Methods: We aimed to assess the association between NMOSD diagnosis and the presence of centrally located lesions at disease onset. We reviewed 102 medical records from the Isfahan MS clinic who presented with cervical cord lesions and 17 MS, 23 NMOSD, and 6 MOG-AD patients were selected. We collected demographic, clinical, and MRI data of patients who had clinical presentations of cervical cord lesion at disease onset, and the characteristics of the lesion were studied. Results: There was an association between NMOSD diagnosis and presence of a centrally located lesion (CLTM) (P < 0.001), presence of an LETM (P < 0.001), and an intermediate to high axial cord expansion (P < 0.001). CLTM and LETM can also be found in MOG-AD patients. The presence of CLTM (sensitivity and specificity: 95.65 and 69.56), possessed higher sensitivity and specificity for NMO diagnosis than LETM presence (sensitivity and specificity: 78.26 and 43.47). Conclusion: A diagnostic criteria including the centrality, location, and expansion of the transverse myelitis lesions, in addition to LETM, may be more accurate in the diagnosis of NMOSD and MOG-AD and their distinction from MS.

Item Type: Article
Keywords: Multiple sclerosis Neuromyelitis optica spectrum disorder Myelin oligodendrocyte glycoprotein antibody disease Transverse myelitis Long extending transverse myelitis NEUROMYELITIS-OPTICA MULTIPLE-SCLEROSIS MATTER INVOLVEMENT CRITERIA LESIONS
Journal or Publication Title: MULTIPLE SCLEROSIS AND RELATED DISORDERS
Journal Index: ISI
Volume: 60
Identification Number: https://doi.org/10.1016/j.msard.2022.103664
ISSN: 2211-0348 2211-0356 J9 - MULT SCLER RELAT DIS
Depositing User: Zahra Otroj
URI: http://eprints.mui.ac.ir/id/eprint/15684

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