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

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


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.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Astrocytes / metabolism
  • Astrocytes / pathology*
  • Biomarkers
  • Cervical Vertebrae / pathology
  • Diagnosis, Differential
  • Female
  • Humans
  • Inositol / deficiency
  • Inositol / metabolism*
  • Male
  • Middle Aged
  • Multiple Sclerosis / diagnosis
  • Multiple Sclerosis / metabolism
  • Multiple Sclerosis / pathology
  • Neuromyelitis Optica / diagnosis
  • Neuromyelitis Optica / metabolism
  • Neuromyelitis Optica / pathology*
  • Spinal Cord / metabolism
  • Spinal Cord / pathology*


  • Biomarkers
  • Inositol