Can Neuromyelitis Optica be differentiated from ‘conventional’ Multiple Sclerosis with ultra-high field brain imaging?
Variability in radiographic expression of NMO complicates the problem of differentiating this entity from ‘conventional MS’ (cMS). Yet, correct diagnosis is essential since prognosis and treatment and prognosis differ substantially in the two conditions. While diagnosis of NMO in prototypical cases can be made confidently on clinical, radiologic and serologic grounds, the existence of ‘hybrid cases’ with considerable burden of brain disease raises the possibility that NMO and MS may comprise heterogeneous and possibly overlapping conditions rather than constituting two distinct diseases. The difficulty in demarcating the boundary between NMO and MS persists despite discovery of a highly specific marker of NMO. This difficulty is highlighted by two recent studies that concluded that distinction between brain MRI of AQP4-seropositive and seronegative patients is often not possible on the basis of their brain MRI findings. A different set of radiologic criteria is needed to differentiate NMO from MS.
Dr. Kister and his team will compare radiolographic features of brain lesions in AQP4-seropositive Neuromyelitis Optica (NMO) and conventional MS (cMS) using Seven-Tesla magnetic resonance imaging of brain; and develop high-specificity/high-sensitivity criteria for differentiating NMO from cMS using Seven-Tesla (7T) magnetic resonance imaging of brain.