Abstract Details

Title Evaluation of Subcortical Pathology and Association with Cognition in Neuromyelitis Optica Spectrum Disorders with Myelin Water Imaging

Topic Autoimmune Neurology

Presentation(s) P10 - Poster Session 10 (11:45 AM-12:45 PM)

Poster/Presentation
Number 14-020

Objective To investigate cerebral normal-appearing white matter (NAWM) and thalamus abnormalities and association to cognition in neuromyelitis optica spectrum disorder (NMOSD) participants compared to healthy controls (HC) using myelin water imaging (MWI).

Background NMOSD, an inflammatory disease of the central nervous system, affects mainly the optic nerves and spinal cord but can also cause focal brain inflammation. Due to inconsistent magnetic resonance imaging (MRI) findings, NAWM and subcortical abnormalities and associations with cognition in NMOSD remain unclear. MWI, an MRI technique that quantifies myelin content through myelin water fraction (MWF), identifies myelin changes not visible on traditional MRI.

Design/Methods 19 NMOSD participants and 21 age- and sex-matched HC were scanned on a 3.0T MRI scanner using a multi-component Driven Equilibrium Single Pulse Observation of T₁ and T₂ (mcDESPOT) protocol. Tissue-compartment and thalamic volumes (normalized to intracranial volume), T₁relaxation time, and MWF were reported. 12 NMOSD participants underwent the Symbol Digit Modalities Test (SDMT) for cognitive evaluation. Group comparisons were performed using Student’s t-test. The association between thalamus metrics and SDMT score was assessed using multiple regression analysis with age as a covariate.

Results Compared to HC, NMOSD participants had higher T₁ (+2.15%, p=0.024) and lower (though not reaching significance) MWF (-2.96%, p=0.068) across NAWM. NMOSD group had reduced, though insignificantly, thalamic volumes compared to HC (-5.35%, p=0.084). There was no significant difference in thalamus MWF (p=0.457) or T₁ (p=0.636) between groups. There was a significant association of SDMT score with thalamus MWF (R=0.602, p=0.0226) and T₁ (R=-0.772, p=0.002).

Conclusions NAWM in NMOSD demonstrates diffuse abnormalities with increased water content and possibly diffuse demyelination that could suggest a disease process overlooked by focal inflammation. Additionally, diffuse thalamic pathology including increased water, demyelination, and atrophy are strong predictors of cognitive performance in NMOSD. Finally, MWI detects myelin integrity changes, providing new insight into NMOSD brain pathology.

Authors/Disclosures
Wendy Tsai, MD PRESENTER	Dr. Tsai has nothing to disclose.
Anna Combes (King'S College London)	No disclosure on file
Shannon Kolind, PhD, MSc, BSc (University of British Columbia)	Dr. Kolind has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Kolind has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Kolind has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Kolind has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. The institution of Dr. Kolind has received research support from Sanofi Genzyme. The institution of Dr. Kolind has received research support from Roche. The institution of Dr. Kolind has received research support from Biogen.
Anthony Traboulsee, MD (University of British Columbia)	Dr. Traboulsee has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Traboulsee has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Traboulsee has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Traboulsee has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Traboulsee has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Traboulsee has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for EMD Serono. Dr. Traboulsee has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Roche. The institution of Dr. Traboulsee has received research support from Roche. The institution of Dr. Traboulsee has received research support from Consortium of MS Centers. The institution of Dr. Traboulsee has received research support from MS Canada. Dr. Traboulsee has received personal compensation in the range of $500-$4,999 for serving as a Workshop Chair with Consortium of MS Centers.

��ɫ��

��ɫ��