This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (71)  • Contact me when this article is cited  Related Content  • Related letter  • Similar articles in this journal  Topic Collections  • Neuro-ophthalmology  • Neurology, Other  • Radiologic Imaging  • Magnetic Resonance Imaging  • Alert me on articles by topic  Social Bookmarking   What's this?

Sean J. Pittock, MD; Brian G. Weinshenker, MD; Claudia F. Lucchinetti, MD; Dean M. Wingerchuk, MD; John R. Corboy, MD; Vanda A. Lennon, MD, PhD

Arch Neurol. 2006;63:964-968.

Background  Neuromyelitis optica (NMO)–IgG is a specific autoantibody marker for NMO. It binds selectively to aquaporin 4 (AQP4), which is highly concentrated in astrocytic foot processes at the blood-brain barrier and is not restricted to optic nerve and spinal cord. Although it is conventionally believed that the brain is spared, brain imaging abnormalities are not uncommon in patients with NMO.

Objective  To investigate the location of brain lesions that are distinctive for NMO with respect to the localization of AQP4 in mammalian brain.

Design  Observational, retrospective case series.

Setting  Clinical serologic cohort of patients tested for NMO-IgG for whom brain MRI images were available.

Patients  We identified 120 patients seropositive for NMO-IgG for whom brain magnetic resonance images were available.

Main Outcome Measure  Magnetic resonance imaging abnormalities.

Results  In 8 patients we observed recurring and distinctive magnetic resonance imaging abnormalities in the hypothalamic and periventricular areas that corresponded to brain regions of high AQP4 expression.

Conclusion  The distribution of NMO-characteristic brain lesions corresponds to sites of high AQP4 expression.

Author Affiliations: Departments of Neurology (Drs Pittock, Weinshenker, Lucchinetti, and Lennon), Laboratory Medicine and Pathology (Drs Pittock and Lennon), and Immunology (Dr Lennon), Mayo Clinic College of Medicine, Rochester, Minn; Department of Neurology, Mayo Clinic, Scottsdale, Ariz (Dr Wingerchuk); and University of Colorado–Denver and Health Sciences Center and Department of Neurology, Denver Veteran's Affairs Medical Center, Denver (Dr Corboy).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTER

A Case of Neuromyelitis Optica With Gadolinium-Enhancing Brain Lesions and Parinaud Syndrome—Reply
Marc Gotkine
Arch Neurol. 2009;66(1):140-141.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The borderland of neuromyelitis optica
Matthews et al.
PN 2009;9:335-340.
ABSTRACT | FULL TEXT  

Sjogren's syndrome myelopathy: spinal cord involvement in Sjogren's syndrome might be a manifestation of neuromyelitis optica
Kim et al.
Mult Scler 2009;15:1062-1068.
ABSTRACT  

Brain abnormalities in Sjogren syndrome with recurrent CNS manifestations: association with neuromyelitis optica
Min et al.
Mult Scler 2009;15:1069-1076.
ABSTRACT  

Symptomatic, radiological and pathological involvement of the hypothalamus in neuromyelitis optica
Viegas et al.
J. Neurol. Neurosurg. Psychiatry 2009;80:679-682.
ABSTRACT | FULL TEXT  

Occurrence of acute large and edematous callosal lesions in neuromyelitis optica
Nakamura et al.
Mult Scler 2009;15:695-700.
ABSTRACT  

Neuromyelitis optica in Brazil: a study on clinical and prognostic factors
Bichuetti et al.
Mult Scler 2009;15:613-619.
ABSTRACT  

What insights have new imaging techniques given into aggressive forms of MS - different forms of MS or different from MS?
Pichiecchio et al.
Mult Scler 2009;15:285-293.
ABSTRACT  

Posterior reversible encephalopathy syndrome in neuromyelitis optica spectrum disorders
Magana et al.
Neurology 2009;72:712-717.
ABSTRACT | FULL TEXT  

A Case of Neuromyelitis Optica With Gadolinium-Enhancing Brain Lesions and Parinaud Syndrome--Reply
Gotkine
Arch Neurol 2009;66:140-141.
FULL TEXT  

Association of the HLA-DRB1 alleles with characteristic MRI features of Asian multiple sclerosis
Matsuoka et al.
Mult Scler 2008;14:1181-1190.
ABSTRACT  

Differential diagnosis of suspected multiple sclerosis: a consensus approach
Miller et al.
Mult Scler 2008;14:1157-1174.
ABSTRACT  

Neuromyelitis Optica and the Optic Neuritis Treatment Trial
Gotkine
Arch Neurol 2008;65:1545-1546.
FULL TEXT  

Spectrum of Pediatric Neuromyelitis Optica
Lotze et al.
Pediatrics 2008;122:e1039-e1047.
ABSTRACT | FULL TEXT  

Functional Consequences of Neuromyelitis Optica-IgG Astrocyte Interactions on Blood-Brain Barrier Permeability and Granulocyte Recruitment
Vincent et al.
J. Immunol. 2008;181:5730-5737.
ABSTRACT | FULL TEXT  

Intractable hiccup and nausea in neuromyelitis optica with anti-aquaporin-4 antibody: a herald of acute exacerbations
Takahashi et al.
J. Neurol. Neurosurg. Psychiatry 2008;79:1075-1078.
ABSTRACT | FULL TEXT  

Neuromyelitis optica immunoglobulins as a marker of disease activity and response to therapy in patients with neuromyelitis optica
Weinstock-Guttman et al.
Mult Scler 2008;14:1061-1067.
ABSTRACT  

CNS aquaporin-4 autoimmunity in children
McKeon et al.
Neurology 2008;71:93-100.
ABSTRACT | FULL TEXT  

Minor salivary gland inflammation in Devic's disease and longitudinally extensive myelitis
Javed et al.
Mult Scler 2008;14:809-814.
ABSTRACT  

To test or not to test: NMO-IgG and optic neuritis
Giovannoni
Neurology 2008;70:2192-2193.
FULL TEXT  

Anterior periventricular linear lesions in optic-spinal multiple sclerosis: a combined neuroimaging and neuropathological study
Matsushita et al.
Mult Scler 2008;14:343-353.
ABSTRACT  

NMO Antibody-Positive Recurrent Optic Neuritis Without Clear Evidence of Transverse Myelitis
Dinkin et al.
Arch Ophthalmol 2008;126:566-570.
FULL TEXT  

Neuromyelitis optica (Devic's disease) in a patient with syphilis
Wilcox et al.
Mult Scler 2008;14:268-271.
ABSTRACT  

Brain magnetic resonance imaging findings in acute relapses of neuromyelitis optica spectrum disorders
Cabrera-Gomez et al.
Mult Scler 2008;14:248-251.
ABSTRACT  

Acute Disseminating Encephalomyelitis in Neuromyelitis Optica: Closing the Floodgates
Eichel et al.
Arch Neurol 2008;65:267-271.
ABSTRACT | FULL TEXT  

Neuromyelitis optica-IgG in childhood inflammatory demyelinating CNS disorders
Banwell et al.
Neurology 2008;70:344-352.
ABSTRACT | FULL TEXT  

Cognitive Functions in Neuromyelitis Optica
Blanc et al.
Arch Neurol 2008;65:84-88.
ABSTRACT | FULL TEXT  

Aquaporin-4, homeostasis, and neurologic disease
Benarroch
Neurology 2007;69:2266-2268.
FULL TEXT  

Pathogenic potential of IgG binding to water channel extracellular domain in neuromyelitis optica
Hinson et al.
Neurology 2007;69:2221-2231.
ABSTRACT | FULL TEXT  

Neuromyelitis Optica in a Mother and Daughter
Braley and Mikol
Arch Neurol 2007;64:1189-1192.
ABSTRACT | FULL TEXT  

Neuromyelitis Optica Is a Variant of Multiple Sclerosis
Galetta and Bennett
Arch Neurol 2007;64:901-903.
FULL TEXT  

Is Neuromyelitis Optica Distinct From Multiple Sclerosis?: Something for "Lumpers" and "Splitters"
Frohman and Kerr
Arch Neurol 2007;64:903-905.
FULL TEXT  

Pattern-specific loss of aquaporin-4 immunoreactivity distinguishes neuromyelitis optica from multiple sclerosis
Roemer et al.
Brain 2007;130:1194-1205.
ABSTRACT | FULL TEXT  

Heterogeneity of aquaporin-4 autoimmunity and spinal cord lesions in multiple sclerosis in Japanese
Matsuoka et al.
Brain 2007;130:1206-1223.
ABSTRACT | FULL TEXT  

Anti-aquaporin-4 antibody is involved in the pathogenesis of NMO: a study on antibody titre
Takahashi et al.
Brain 2007;130:1235-1243.
ABSTRACT | FULL TEXT  

A secondary progressive clinical course is uncommon in neuromyelitis optica
Wingerchuk et al.
Neurology 2007;68:603-605.
ABSTRACT | FULL TEXT