Frequency of new asymptomatic MRI lesions during attacks and follow-up of patients with NMOSD in a real-world setting

Mult Scler. 2023 Sep;29(10):1240-1249. doi: 10.1177/13524585231187120. Epub 2023 Jul 25.

Abstract

Background: We aimed to assess the frequency of new asymptomatic lesions on brain and spinal imaging (magnetic resonance imaging (MRI)) and their association with subsequent relapses in a large cohort of neuromyelitis optica spectrum disorder (NMOSD) patients in Argentina.

Methods: We retrospectively reviewed 675 MRI (225 performed during an attack and 450 during the relapse-free period (performed at least 3 months from the last attack)) of NMOSD patients who had at least 2 years of clinical and MRI follow-up since disease onset. Kaplan-Meier (KM) curves were used for depicting time from remission MRI to subsequent relapse.

Results: We included 135 NMOSD patients (64.4% were aquaporin-4-immunoglobulin G (AQP4-IgG)-positive). We found that 26 (19.26%) and 66 (48.88%) of patients experienced at least one new asymptomatic MRI lesion during both the relapse-free period and attacks, respectively. The most frequent asymptomatic MRI lesions were optic nerves followed by short-segment myelitis during the relapse-free period and attacks. KM curves did not show differences in the time taken to develop a new relapse.

Conclusion: Our findings showed that new asymptomatic lesions are relatively frequent. However, the presence of new asymptomatic MRI lesions during the relapse-free period and at relapses was not associated with a shorter time to developing subsequent relapses.

Keywords: Latin America; MRI; Neuromyelitis optica spectrum disorder; asymptomatic MRI lesions; relapses.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aquaporin 4
  • Autoantibodies
  • Brain / diagnostic imaging
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging
  • Neuromyelitis Optica* / complications
  • Neuromyelitis Optica* / diagnostic imaging
  • Retrospective Studies

Substances

  • Aquaporin 4
  • Autoantibodies