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

Authors

  • Olga Ciccarelli PhD,

    Corresponding author
    1. National Institute for Health Research, University College London Hospitals Biomedical Research Centre, London
    • Department of Brain Repair and Rehabilitation, Nuclear Magnetic Resonance Research Unit, University College London Institute of Neurology, London
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  • David L. Thomas PhD,

    1. Department of Brain Repair and Rehabilitation, Nuclear Magnetic Resonance Research Unit, University College London Institute of Neurology, London
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  • Enrico De Vita PhD,

    1. Department of Brain Repair and Rehabilitation, Nuclear Magnetic Resonance Research Unit, University College London Institute of Neurology, London
    2. Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London
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  • Claudia A. M. Wheeler-Kingshott PhD,

    1. Department of Neuroinflammation, Nuclear Magnetic Resonance Unit, University College London Institute of Neurology, London
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  • Carolina Kachramanoglou MRCP,

    1. Department of Brain Repair and Rehabilitation, Nuclear Magnetic Resonance Research Unit, University College London Institute of Neurology, London
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  • Raj Kapoor FRCP,

    1. National Institute for Health Research, University College London Hospitals Biomedical Research Centre, London
    2. National Hospital for Neurology and Neurosurgery, London
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  • Siobhan Leary MD,

    1. National Hospital for Neurology and Neurosurgery, London
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  • Lucy Matthews PhD,

    1. Department of Clinical Neurology, John Radcliffe Hospital, Oxford, United Kingdom
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  • Jacqueline Palace FRCP,

    1. Department of Clinical Neurology, John Radcliffe Hospital, Oxford, United Kingdom
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  • Declan Chard PhD,

    1. National Institute for Health Research, University College London Hospitals Biomedical Research Centre, London
    2. Department of Neuroinflammation, Nuclear Magnetic Resonance Unit, University College London Institute of Neurology, London
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  • David H. Miller FRCP,

    1. National Institute for Health Research, University College London Hospitals Biomedical Research Centre, London
    2. Department of Neuroinflammation, Nuclear Magnetic Resonance Unit, University College London Institute of Neurology, London
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  • Ahmed T. Toosy PhD,

    1. Department of Brain Repair and Rehabilitation, Nuclear Magnetic Resonance Research Unit, University College London Institute of Neurology, London
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  • Alan J. Thompson FRCP

    1. Department of Brain Repair and Rehabilitation, Nuclear Magnetic Resonance Research Unit, University College London Institute of Neurology, London
    2. National Institute for Health Research, University College London Hospitals Biomedical Research Centre, London
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Address correspondence to Dr Ciccarelli; Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, United Kingdom. E-mail: o.ciccarelli@ucl.ac.uk

Abstract

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 1H-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. Ann Neurol 2013;74:301–305

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