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Published online before print November 21, 2007, 10.1148/radiol.2461062075
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(Radiology 2008;246:222-228.)
© RSNA, 2007

Neuroradiology

Pathogenesis of Normal-appearing White Matter Damage in Neuromyelitis Optica: Diffusion-Tensor MR Imaging1

Chunshui Yu, MD, Fuchun Lin, PhD, Kuncheng Li, MD, Tianzi Jiang, PhD, Wen Qin, MS, Hong Sun, MD, and Piu Chan, MD

1 From the Departments of Radiology (C.Y., K.L., W.Q.) and Neurology (H.S., P.C.), Xuanwu Hospital, Capital University of Medical Sciences, 45 Chang-Chun St, Xuanwu District, Beijing 100053, People's Republic of China; and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, People's Republic of China (F.L., T.J.). Received December 6, 2006; revision requested February 15, 2007; revision received March 21; final version accepted May 9. Supported in part by the Natural Science Foundation of China (nos. 30670601, 30470519, 30425004 and 30570509), Beijing Scientific and Technological New Star Program (2005B21), and the National Key Basic Research and Development Program (2004CB318107). Address correspondence to K.L. (e-mail: kunchengli1955{at}yahoo.com.cn).

Purpose: To prospectively evaluate diffusion indexes of the corticospinal tract (CST), corpus callosum (CC), optic radiation (OR), and cingulum in patients with neuromyelitis optica (NMO) without visible lesions in the brain.

Materials and Methods: All participants provided informed consent, and the study was approved by the institutional review board. Nineteen patients with NMO (one man, 18 women; mean age, 35.1 years; range, 19–55 years) with normal brain magnetic resonance (MR) imaging findings and 19 sex- and age-matched healthy control subjects were examined with diffusion-tensor MR imaging. The CST, CC, OR, and cingulum were globally and regionally analyzed by using mean diffusivity, fractional anisotropy, and primary ({lambda}1) and transverse ({lambda}23) eigenvalues. Correlations of diffusion indexes of the CST and OR with the pyramidal and visual components of the Kurtzke Functional Systems (KFS) and Expanded Disability Status Scale scores were also investigated. Student t testing and Pearson correlation were performed.

Results: As compared with values in control subjects, both global and regional analyses showed significant (P < .01) increases in mean diffusivity and {lambda}23 of the CST and OR but not in any of the diffusion indexes of the CC and cingulum in patients with NMO. In patients with NMO, mean diffusivity (r = 0.556, P = .013) and {lambda}1 (r = 0.556, P = .013) of the CST were correlated with pyramidal KFS scores, and mean diffusivity (r = 0.523, P = .022) and {lambda}1 (r = 0.504, P = .027) of the OR were correlated with visual KFS scores.

Conclusion: Axonal degeneration secondary to lesions in the spinal cord and optic nerves is a cause of normal-appearing white matter damage in NMO.

Supplemental material: http://radiology.rsnajnls.org/cgi/content/full/2461062075/DC1

© RSNA, 2007