Contributions
Abstract: P654
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Diagnosis and differential diagnosis
Objective: Test the ability of a brain and spinal cord MRI criteria to differentiate Aquaporin-4- and MOG-disease from MS. MRI criteria was further tested in patients with CIS and pediatric MS.
Background: MOG-disease, Aquaporin-4-positive neuromyelitis optica and neuromyelitis optica spectrum disorders can present clinical and radiological features strikingly similar to those of MS. Previously, diagnostic criteria based on brain MRI have been proposed to distinguish between the three demyelinating diseases, but spinal cord imaging and its relevance in CIS have not been evaluated. Simple brain and spinal cord MRI criteria may help separate these three inflammatory CNS diseases both in adults and children, aiding in early diagnostic decision-making, such as need for antibody testing.
Design/Methods: We included 150 participants (23 with Aquaporin-4-positive neuromyelitis optica, 14 with MOG-disease, 20 with Neuromyelitis optica spectrum disorder, 48 with adult-onset relapsing remitting MS, 24 with pediatric-onset MS and 21 with clinically isolated syndrome). Brain and spinal cord MRI scans were anonymised and scored by 2 separate raters, based on two sets of criteria: one previously described by Matthews and colleagues (including presence of at least one lesion adjacent to the body of lateral ventricle and in the inferior temporal lobe, or presence of subcortical U-fiber lesion or a Dawson´s finger-type lesion), and a modified version including spinal cord features (non-longitudinally extensive cervical lesion).
Results: MRI brain and spinal cord lesion criteria were able to separate relapsing remitting MS with 100% sensitivity and 87% specificity from AQP4-positive neuromyelitis optica; and with 100% sensitivity and 79% specificity from MOG-disease. Additionally, brain and spinal cord criteria showed 100% sensitivity and specificity in patients presenting optic neuritis. Brain and spinal cord criteria were less sensitive in patients with CIS and in pediatric MS patients.
Conclusions: Our data suggest radiological criteria can be useful to separate MS from MOG- and Aquaporin-4 disorders, in particular in patients with optic neuritis. Further work is needed to support their use in CIS.
Disclosure: Bensi C: nothing to disclose
Marrodan M: nothing to disclose
Gonzalez A: nothing to disclose
Chertcoff A: nothing to disclose
Osa Sanz E: nothing to disclose
Schteinschnaider A: nothing to disclose
Correale J: board member of Merck-Serono Argentina, Novartis Argentina, Genzyme LATAM, Genzyme global, Biogen-Idec LATAM, and Merck-Serono LATAM. Dr. Correale has received reimbursement for developing educational presentations for Merck-Serono Argentina, Merck-Serono LATAM, Biogen-Idec Argentina, Genzyme Argentina, Novartis Argentina, Novartis LATAM, Novartis Global, and TEVA Argentina as well as professional travel/accommodations stipends
Farez MF: has received travel accommodations from Teva, Merck-Serono, Biogen-Idec and Novartis. Dr. Farez has also received research funds from Biogen-Idec and Novartis Argentina
Abstract: P654
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Diagnosis and differential diagnosis
Objective: Test the ability of a brain and spinal cord MRI criteria to differentiate Aquaporin-4- and MOG-disease from MS. MRI criteria was further tested in patients with CIS and pediatric MS.
Background: MOG-disease, Aquaporin-4-positive neuromyelitis optica and neuromyelitis optica spectrum disorders can present clinical and radiological features strikingly similar to those of MS. Previously, diagnostic criteria based on brain MRI have been proposed to distinguish between the three demyelinating diseases, but spinal cord imaging and its relevance in CIS have not been evaluated. Simple brain and spinal cord MRI criteria may help separate these three inflammatory CNS diseases both in adults and children, aiding in early diagnostic decision-making, such as need for antibody testing.
Design/Methods: We included 150 participants (23 with Aquaporin-4-positive neuromyelitis optica, 14 with MOG-disease, 20 with Neuromyelitis optica spectrum disorder, 48 with adult-onset relapsing remitting MS, 24 with pediatric-onset MS and 21 with clinically isolated syndrome). Brain and spinal cord MRI scans were anonymised and scored by 2 separate raters, based on two sets of criteria: one previously described by Matthews and colleagues (including presence of at least one lesion adjacent to the body of lateral ventricle and in the inferior temporal lobe, or presence of subcortical U-fiber lesion or a Dawson´s finger-type lesion), and a modified version including spinal cord features (non-longitudinally extensive cervical lesion).
Results: MRI brain and spinal cord lesion criteria were able to separate relapsing remitting MS with 100% sensitivity and 87% specificity from AQP4-positive neuromyelitis optica; and with 100% sensitivity and 79% specificity from MOG-disease. Additionally, brain and spinal cord criteria showed 100% sensitivity and specificity in patients presenting optic neuritis. Brain and spinal cord criteria were less sensitive in patients with CIS and in pediatric MS patients.
Conclusions: Our data suggest radiological criteria can be useful to separate MS from MOG- and Aquaporin-4 disorders, in particular in patients with optic neuritis. Further work is needed to support their use in CIS.
Disclosure: Bensi C: nothing to disclose
Marrodan M: nothing to disclose
Gonzalez A: nothing to disclose
Chertcoff A: nothing to disclose
Osa Sanz E: nothing to disclose
Schteinschnaider A: nothing to disclose
Correale J: board member of Merck-Serono Argentina, Novartis Argentina, Genzyme LATAM, Genzyme global, Biogen-Idec LATAM, and Merck-Serono LATAM. Dr. Correale has received reimbursement for developing educational presentations for Merck-Serono Argentina, Merck-Serono LATAM, Biogen-Idec Argentina, Genzyme Argentina, Novartis Argentina, Novartis LATAM, Novartis Global, and TEVA Argentina as well as professional travel/accommodations stipends
Farez MF: has received travel accommodations from Teva, Merck-Serono, Biogen-Idec and Novartis. Dr. Farez has also received research funds from Biogen-Idec and Novartis Argentina