Acute optic nerve lesions in first-ever NMOSD-related optic neuritis using conventional brain MRI: A Latin American multicenter study
Por:
Carnero Contentti E., Delgado-García G., López P.A., Criniti J., Pettinicchi J.P., Correa-Díaz E.P., Soto de Castillo I., Daccach Marques V., Tkachuk V., Cristiano E., Serva Braga Diéguez G., dos Santos A.C., Castillo M.C., Patrucco L., Álvarez Pucha M.O., Miño Zambrano J.E., Gómez-Figueroa E., Rivas-Alonso V., Flores-Rivera J., Caride A., Rojas J.I.
Publicada:
1 ene 2020
Resumen:
Background: Few studies regarding MRI-defined acute optic nerve lesions (aONL) in patients with first-ever neuromyelitis optica spectrum disorder (NMOSD)-related optic neuritis (ON) have been reported worldwide and none of them was conducted in Latin America (LATAM). Therefore, we aimed to assess the frequency of aONL at disease onset using conventional brain MRI in LATAM. Methods: We reviewed the medical records and brain MRIs (=30 days from ON onset) of patients with ON as first lifetime NMOSD attack. Patients from Argentina (n=48), Ecuador (n=24), Brazil (n=22), Venezuela (n=10) and Mexico (n=8) were included, and further divided into two subgroups according to either presence (P-MRI) or absence (A-MRI) of aONL (T2 hyperintensity and/or contrast enhancement). Clinical, paraclinical, imaging and prognostic data were compared. Results: A total of 112 patients were included and aONL were found in 86 (76.7%) at disease onset. Aquaporin-4 antibodies were detected in 69.6%. Non-Caucasian patients comprised 59.8% of the total cohort. In P-MRI, conventional brain MRI showed isolated or combined unilateral (54.4%, [8.5% of these aONL were associated with chiasmatic lesions]) and bilateral (46.6%, [35.9% of these aONL were associated with chiasmatic lesions]) lesions. Thus, 100% of chiasmatic lesions were associated with unilateral or bilateral lesions. No statistically significant differences were found in age, gender, ethnicity, clinical course, mean follow-up time, disability, and spinal cord MRI findings. However, rituximab use was higher in P-MRI than in A-MRI (p=0.006). Conclusions: More than three quarters of LATAM patients with first-ever NMOSD-related ON have aONL detected by brain MRI. Unilateral lesions were the most common finding. Further studies including different ethnicities are needed to assess the generalizability of our results. © 2020 Elsevier B.V.
Filiaciones:
Carnero Contentti E.:
Neuroimmunology Unit, Department of Neuroscience, Hospital Alemán, Buenos Aires, Argentina
Delgado-García G.:
Clinical Laboratory of Neurodegenerative Diseases, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
Programa de Maestría y Doctorado en Ciencias Médicas, Odontológicas y de la Salud (PMDCMOS), Universidad Nacional Autónoma de México, Mexico City, Mexico
López P.A.:
Neuroimmunology Unit, Department of Neuroscience, Hospital Alemán, Buenos Aires, Argentina
Criniti J.:
Neuroimmunology Unit, Department of Neuroscience, Hospital Alemán, Buenos Aires, Argentina
Pettinicchi J.P.:
Neuroimmunology Unit, Department of Neuroscience, Hospital Alemán, Buenos Aires, Argentina
Correa-Díaz E.P.:
Universidad Central del Ecuador
Pontificia Universidad Católica del Ecuador
Soto de Castillo I.:
Neurology Department, Hospital Universitario de Maracaibo, Maracaibo, Venezuela
Daccach Marques V.:
Department of Neurosciences and Behavioral Sciences, Hospital das Clínicas, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
Tkachuk V.:
Neuroimmunology Section, Department of Neurology, Hospital de Clínicas “José de San Martín”, Buenos Aires, Argentina
Cristiano E.:
Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Buenos Aires, Argentina
Serva Braga Diéguez G.:
Department of Neurosciences and Behavioral Sciences, Hospital das Clínicas, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
dos Santos A.C.:
Department of Neurosciences and Behavioral Sciences, Hospital das Clínicas, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
Castillo M.C.:
Neurology Department, Hospital Universitario de Maracaibo, Maracaibo, Venezuela
Patrucco L.:
Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Buenos Aires, Argentina
Álvarez Pucha M.O.:
Pontificia Universidad Católica del Ecuador
Miño Zambrano J.E.:
Hospital Carlos Andrade Marín, Quito, Ecuador
Gómez-Figueroa E.:
Demyelinating Diseases Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
Rivas-Alonso V.:
Demyelinating Diseases Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
Flores-Rivera J.:
Clinical Laboratory of Neurodegenerative Diseases, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
Demyelinating Diseases Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
Division of Neurology, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
Caride A.:
Neuroimmunology Unit, Department of Neuroscience, Hospital Alemán, Buenos Aires, Argentina
Rojas J.I.:
Centro de Esclerosis Múltiple de Buenos Aires (CEMBA), Buenos Aires, Argentina
|