Abstract General Information


Brain MRI features at chronic phase in NMOSD patients


Introduction: Chronic brain lesions are under reported compared to acute lesions in the spectrum of neuromyelitis optica (NMOSD). Its associations range from astrocytopathy itself, comorbidities and no specific lesions.
Objectives: To describe the frequency, characteristics and distribution of chronic lesions in patients with NMOSD in remission, with clinical associations.
Methods: In this cross-sectional study, we evaluated anti-aquaporin-4 positive NMOSD patients who were in remission for at least 12 weeks. All patients underwent brain MRI at the same 3.0 T scanner and the images were reviewed by two experienced neuroradiologists.
Results: A total of 60 patients (54/6 women/men; mean age +- SD of 42.2 +- 11.2 years) were included. MRI abnormalities were detected in 45 (75%) patients. Encephalic typical NMOSD features occurred in 30 (50%) patients, classified in 5 categories (periventricular hyperintensity (31.7%) postrema area lesion (31.7%); large hemispheric lesions (10%); corticospinal tracts lesions (6.7%); diencephalon (1.7%)). Nonspecific lesions were identified in 30 patients and other types of lesions in 18 patients. Only 2 patients showed typical MS lesions. We found significant associations between brain MRI abnormalities and longer disease duration (p=0.002) delayed diagnosis (p=0.004) and number of relapses (p=0.044). No associations were found between MRI typical NMOSD lesions and age, EDSS and vascular/autoimmune comorbidities.
Conclusions: Brain MRI abnormalities are frequent in NMOSD patients and are associated with disease duration, delayed diagnosis and previous number of relapses.


Epidemiology and MRI


Mateus Boaventura, Diego Fragoso, Isabella Avolio, Samira Luisa Pereira Apostolos, Dagoberto Callegaro, Claudia da Costa Leite, Carolina M Rimkus