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Abstract Details

White Matter Myelin Alterations are Diffuse in Neuromyelitis Optica Spectrum Disorders and Prevail on Axonal Damage
Multiple Sclerosis
P13 - Poster Session 13 (5:30 PM-6:30 PM)
9-019
To assess whether a gradient of damage originating from the ventricular system involves the normal appearing white matter (NAWM) in neuromyelitis optica spectrum disorders (NMOSD) by using diffusion tensor imaging (DTI) measures and the T1/T2-weighted ratio.
Cerebrospinal fluid (CSF)-mediated factors are under investigation to explain NAWM abnormalities in multiple sclerosis (MS), but less is known about CSF influence on damage distribution in other neuroinflammatory conditions like NMOSD. Beside DTI measures, the T1/T2-weighted ratio has been proposed as an emerging tool to evaluate myelin content and microstructural damage in brain white and grey matter.

Twenty aquaporine-4 positive NMOSD, 20 MS and 20 matched healthy controls (HC) underwent a 3.0 T MRI. Fractional anisotropy (FA), mean diffusivity (MD) and T1/T2-weighted ratio maps were obtained. Quantitative variables were compared between groups globally and as functions of CSF distance measured within concentric bands originating from the CSF interface.
FA values were similar between NMOSD patients and HC, whereas they were significantly reduced in the MS population, especially in the bands nearer to the CSF, compared to HC (p=0.01) and NMOSD (p=0.01). MD was significantly higher in the bands near the CSF interface in MS and NMOSD compared to HC (p=0.01, p=0.04 respectively), with NMOSD patients showing intermediate values. NMOSD patients had a severe reduction of the T1/T2-weighted ratio among all concentric bands compared to the other groups (p<0.001). MS patients had a milder T1/T2-weighted ratio reduction.

NAWM abnormalities occur in NMOSD, with a prominence of diffuse myelin alteration instead of axonal damage. Such alterations are not influenced by CSF distance, confirming the serological origin of the pathogenetic element in this condition. Moreover, the discrepancy between DTI measures and T1/T2-weighted ratio could mirror an increase of tissue extracellular water which could be specific for a channelopathy.
Authors/Disclosures
Laura Cacciaguerra, MD, PhD (Mayo Clinic)
PRESENTER 		Dr. Cacciaguerra has nothing to disclose.
Maria A. Rocca (Neuroimaging Research Unit) Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen, Bristol Myers Squibb, Eli Lilly, Janssen, Roche. Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for AstraZaneca, Biogen, Bristol Myers Squibb, Bromatech, Celgene, Genzyme, Horizon Therapeutics Italy, Merck Serono SpA, Novartis, Roche, Sanofi and Teva. The institution of Maria Assunta Rocca has received research support from MS Society of Canada, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Loredana Storelli Loredana Storelli has nothing to disclose.
Marta Radaelli (Hsr) Marta Radaelli has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck Serono. Marta Radaelli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Marta Radaelli has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Marta Radaelli has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Sanofi-Genzyme.
Vittorio Martinelli (S. Raffaele Hospital) Dr. Martinelli has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis, Biogen, Sanofi Genzyme, TEVA and Merck. Dr. Martinelli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck .
Massimo Filippi, MD, FÂ鶹´«Ã½Ó³»­ (Ospedale San Raffaele, Neuroimaging Research Unit) Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.