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Ann Neurol. 2013 Aug;74(2):301-5. doi: 10.1002/ana.23909. Epub 2013 Sep 4.

Low myo-inositol indicating astrocytic damage in a case series of neuromyelitis optica.

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Department of Brain Repair and Rehabilitation, Nuclear Magnetic Resonance Research Unit, University College London Institute of Neurology, London; National Institute for Health Research, University College London Hospitals Biomedical Research Centre, London.


Astrocytic necrosis is a prominent pathological feature of neuromyelitis optica (NMO) lesions and is clinically relevant. We report 5 NMO-related cases, all with longitudinally extensive lesions in the upper cervical cord, who underwent cervical cord (1) H-magnetic resonance spectroscopy. Lower myo-inositol/creatine values, suggesting astrocytic damage, were consistently found within the NMO lesions when compared with healthy controls and patients with multiple sclerosis (MS), who showed at least 1 demyelinating lesion at the same cord level. Therefore, the in vivo quantification of myo-inositol may distinguish NMO from MS. This is an important step toward developing imaging markers for clinical trials in NMO.

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