Low Myo-inositol indicating astrocytic damage in a case series of neuromyelitis optica
Ciccarelli O., Thomas DL., De Vita E., Wheeler-Kingshott CAM., Kachramanoglou C., Kapoor R., Leary S., Matthews L., Palace J., Chard D., Miller DH., Toosy AT., Thompson AJ.
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. © 2013 American Neurological Association.