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JAMA Neurol. 2015 Jul;72(7):815-22. doi: 10.1001/jamaneurol.2015.0248.

Use of Advanced Magnetic Resonance Imaging Techniques in Neuromyelitis Optica Spectrum Disorder.

Author information

  • 1ICube (UMR 7357, UdS, Centre National de la Recherche Scientifique), Fédération de médecine translationelle de Strasbourg, Université de Strasbourg, Strasbourg, France2Department of Radiology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
  • 2Centre National de la Recherche Scientifique, Grenoble Image Parole Signal Automatique, Grenoble, France.
  • 3CIEM MS Research Center, University of Minas Gerais, Minas Gerais, Brazil.
  • 4Department of Neurology, Oxford University Hospital Trust, Oxford, England.
  • 5Department of Neurobiology, Institute of Molecular Medicine, University of Southern Denmark, Odense7Department of Neurology, Vejle Hospital, Vejle, Denmark.
  • 6Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston.
  • 7Department of Neurology and Neurophysiology, National Pediatric Hospital Dr Juan P. Garrahan, Buenos Aires, Argentina.
  • 8Department of Neurology, University of Pennsylvania, Philadelphia11Division of Child Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
  • 9Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas13Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas.
  • 10Department of Neurology, University of Colorado Denver, Aurora15Department of Ophthalmology, University of Colorado Denver, Aurora.
  • 11Department of Neurology, Johns Hopkins University, Baltimore, Maryland.
  • 12Institute of Biomedical Research August Pi Sunyer-Hospital Clínic de Barcelona, Barcelona, Spain.
  • 13Department of Multiple Sclerosis Therapeutics, Tohoku University Graduate School of Medicine, Sendai, Japan.
  • 14University Department of Medicine, Research Center of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, People's Republic of China.
  • 15Neuroimmunology and Multiple Sclerosis Research Section, University Hospital Zurich, Zurich, Switzerland21Department of Neurology, University Hospital Zurich, Zurich, Switzerland22Neuroscience Center Zurich, Federal Technical High School Zurich, Zurich, S.
  • 16NeuroCure Clinical Research Center, Charité University Medicine, Berlin, Germany25Clinical and Experimental Multiple Sclerosis Research Center, Charité University Medicine, Berlin, Germany26Department of Neurology, Charité University Medicine, Berlin, Ger.
  • 17Department of Neurology, Research Institute, Goyang, Korea28Hospital of National Cancer Center, Goyang, Korea.
  • 18Neurology Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France30Clinical Investigation Center (INSERM 1434), Hôpitaux Universitaires de Strasbourg, Strasbourg, France31UMR INSERM 1119 and Fédération de médecine translationelle, Strasbourg.
  • 19CHU de Fort de France, Martinique.
  • 20CHU, Lyon, France.
  • 21Duke University School of Medicine, Durham, North Carolina.
  • 22Erasmus MC, Rotterdam, the Netherlands.
  • 23Griffith University, Southport, Queensland, Australia.
  • 24Mayo Clinic, Scottsdale, Arizona.
  • 25Nitte University, Mangalore, Karnataka, India.
  • 26Prasat Neurological Institute, Bangkok, Thailand.
  • 27Ruhr University, Bochum, Germany.
  • 28Siriraj Hospital, Mahidol University, Bangkok, Thailand.
  • 29Stanford University School of Medicine, Palo Alto, California.
  • 30St Josef Hospital, Bochum, Germany.
  • 31The GJCF, San Diego, California.
  • 32Mount Sinai Hospital, New York, New York.
  • 33Thomas Jefferson University, Philadelphia, Pennsylvania.
  • 34University of California, Los Angeles.
  • 35University of California, San Francisco.
  • 36University of Düsseldorf, Düsseldorf, Germany.
  • 37University of Michigan, Ann Arbor.
  • 38Walton Center, Liverpool, England.
  • 39Yale University School of Medicine, New Haven, Connecticut.


Brain parenchymal lesions are frequently observed on conventional magnetic resonance imaging (MRI) scans of patients with neuromyelitis optica (NMO) spectrum disorder, but the specific morphological and temporal patterns distinguishing them unequivocally from lesions caused by other disorders have not been identified. This literature review summarizes the literature on advanced quantitative imaging measures reported for patients with NMO spectrum disorder, including proton MR spectroscopy, diffusion tensor imaging, magnetization transfer imaging, quantitative MR volumetry, and ultrahigh-field strength MRI. It was undertaken to consider the advanced MRI techniques used for patients with NMO by different specialists in the field. Although quantitative measures such as proton MR spectroscopy or magnetization transfer imaging have not reproducibly revealed diffuse brain injury, preliminary data from diffusion-weighted imaging and brain tissue volumetry indicate greater white matter than gray matter degradation. These findings could be confirmed by ultrahigh-field MRI. The use of nonconventional MRI techniques may further our understanding of the pathogenic processes in NMO spectrum disorders and may help us identify the distinct radiographic features corresponding to specific phenotypic manifestations of this disease.

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