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Meta-Analysis
. 2024 Dec 16;272(1):77.
doi: 10.1007/s00415-024-12827-x.

Magnetic resonance imaging-based biomarkers of multiple sclerosis and neuromyelitis optica spectrum disorder: a systematic review and meta-analysis

Omid Mirmosayyeb  1 , Mohammad Yazdan Panah  2 , Elham Moases Ghaffary  3 , Saeed Vaheb  4 , Hamed Ghoshouni  4 , Vahid Shaygannejad  4 , Nandor K Pinter  5
Affiliations
Meta-Analysis

Magnetic resonance imaging-based biomarkers of multiple sclerosis and neuromyelitis optica spectrum disorder: a systematic review and meta-analysis

Omid Mirmosayyeb et al. J Neurol. .

Abstract

Background/objective: Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are neuroinflammatory conditions with overlapping clinical and imaging features. Distinguishing between these diseases is crucial for appropriate diagnosis and management. Magnetic resonance imaging (MRI) may have the potential to differentiate these disorders. Nonetheless, studies exhibit inconsistencies regarding which MRI measurements most effectively distinguish between these disorders. Hence, this review aimed to evaluate the differences in MRI volumetry between people with MS (PwMS) and people with NMOSD (PwNMOSD).

Methods: A systematic search was conducted across PubMed/MEDLINE, Embase, Scopus, and Web of Science up to May 12, 2024, to identify studies assessing conventional and volumetric MRI in PwMS and PwNMOSD. The standard mean difference (SMD) of MRI measurements and its 95% confidence interval (CI) were estimated using R version 4.4.0 with a random-effects model.

Results: Forty-eight original studies that assessed conventional MRI measurements in 2592 PwMS and 1979 PwNMOSD were included. The meta-analysis revealed that PwMS had significantly higher T2 lesion volume (SMD = 1.51, 95% CI: 0.53 to 2.48, p = 0.002) and T1 lesion count (SMD = 1.08, 95% CI: 0.56 to 1.6, p < 0.001) than PwNMOSD. PwMS also exhibited significantly reduced thalamic volume (SMD = -1.26, 95% CI: -1.8 to -0.73, p < 0.001) and grey matter volume (GMV) (SMD = -0.65, 95% CI: -0.92 to -0.37, p < 0.001). Other MRI volumetry, such as the brain and putamen volumes, showed more pronounced atrophy in PwMS.

Conclusion: Significant differences in MRI volumetry between MS and NMOSD highlight the potential of MRI as a critical diagnostic tool. These findings emphasize the need for standardized MRI protocols and advanced imaging techniques to enhance diagnostic accuracy and clinical management of these conditions.

Keywords: Diagnosis; Magnetic resonance imaging; Multiple sclerosis; Neuromyelitis optica spectrum disorder.

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Conflict of interest statement

Declarations. Conflicts of interest: The authors declare no competing interest regarding the publication of this paper. Compliance with ethical standards: Not applicable. Informed consent: This manuscript has been approved for publication by all authors.

References

References:

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    1. Marrodan M, Gaitán MI, Correale J (2020) Spinal cord involvement in ms and other demyelinating diseases. Biomedicines 8(5):130 - PubMed - PMC
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    1. Bagherieh S et al (2023) Worldwide prevalence of neuromyelitis optica spectrum disorder (NMOSD) and neuromyelitis optica (NMO): a systematic review and meta-analysis. Neurol Sci 44(6):1905–1915 - PubMed
    1. Holzer H, Characterisation of Anti-Aquaporin-1 and Anti-Aquaporin-4 Antibodies in Neuromyelitis Optica Spectrum Disorders (NMOSD). Medical University of Innsbruck

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