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BMC Neurology

, 14:246

Demyelinating diseases


BackgroundSpinal cord lesions is one of the predominant characteristics in patients with neuromyelitis optica spectrum disorders NMOSD. Interestingly, mounting evidence indicates that spinal cord atrophy SCA is one of common clinical features in multiple sclerosis MS patients, and correlates closely with the neurological disability. However, Clinical studies related to the SCA aspects of NMOSD are still scarce.

MethodsWe retrospectively analyzed 185 patients with NMOSD, including 23 patients with SCA and 162 patients without SCA. Data were collected regarding clinical characteristics, laboratory tests, and magnetic resonance imaging findings.

Results12.4% of patients had SCA in NMOSD. Patients with SCA had a longer disease duration and higher EDSS at clinical onset and last visit. More importantly, SCA patients were more prone to reach disability milestones EDSS ≥ 6.0. Bowel or bladder dysfunction, movement disorders, and sensory disturbances symptoms were more common in patients with SCA. ESR and CRP were significantly higher in patients with SCA than those without SCA. Patients with SCA were more frequently complicated with cervical cord lesions. However, the ARR, progression index, seropositive rate of NMO-IgG and OCB were similar in the two groups. Futhermore, LETM did not differ significantly between patients with SCA and without SCA in NMOSD patients.

ConclusionsPatients with SCA might have longer disease duration, more severe clinical disability, and more frequently complicated with cervical spinal cord lesions. SCA might be predictive of the more severe neurologic dysfunction and worse prognosis in NMOSD. Inflammation contributes to the development of SCA in NMOSD.

KeywordsNeuromyelitis optica spectrum disorders Spinal cord atrophy Longitudinally extensive transverse myelitis Magnetic resonance imaging AbbreviationNMOSDNeuromyelitis optica spectrum disorders

SCASpinal cord atrophy

ARRAnnualized relapse rate

EDSSExpanded disability status scale

PIProgression index

IHNIntractable hiccup and nausea

SCA durationDuration between at the onset of NMOSD and at the appearance of SCA

NMO-IgGAnti-AQP4IgG autoantibodies

LETMLongitudinally extensive transverse myelitis

STMShorter transverse myelitis

SCSpinal cord

CSFCerebrospinal fluid

OCBOligoclonal banding

CRPC-reactive protein

ESRErythrocyte sedimentation rate

ANAAntinuclear antibodies

SSAAnti-SSA-Ro antibodies

SSBAnti-SSB-La antibodies

RFRheumatoid factor

MRIMagnetic resonance imaging

Electronic supplementary materialThe online version of this article doi:10.1186-s12883-014-0246-4 contains supplementary material, which is available to authorized users.

Yanqiang Wang, Aimin Wu, Xiaoyu Chen contributed equally to this work.

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Autor: Yanqiang Wang - Aimin Wu - Xiaoyu Chen - Lei Zhang - Yinyao Lin - Shaoyang Sun - Wei Cai - Bingjun Zhang - Zhuang Kang -


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