Scholarlink

Background <p>Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune astrocytopathy where disability is largely relapse-driven. Cerebrovascular risk factors (cVRFs) may exacerbate astrocytic and small-vessel injury. Therefore, we investigated their impact on MRI damage and disability in NMOSD.</p> Methods <p>Twenty-eight aquaporin 4 immunoglobulin G-positive NMOSD patients and 56 age- and sex-matched healthy controls (HC) underwent 3T brain and cervical MRI, cVRF and neurological assessment, including the Expanded Disability Status Scale (EDSS). Brain T2-hyperintense white matter lesion volume (WMLV), normalized global and regional volumes, normal-appearing WM (NAWM) fractional anisotropy (FA) and mean diffusivity (MD), diffusion tensor imaging analysis along the perivascular spaces (DTI-ALPS) index, spinal cord lesion volume (SCLV) and normalized cross-sectional area (nCSA) were quantified.</p> Results <p>cVRF were present in 57% of NMOSD and 39% of HC, with smoking being the most frequent (all FDR-p = 0.734). Compared to HC, NMOSD showed significantly higher brain WMLV and SCLV, lower normalized brain (NBV), and deep gray matter volume (nDGMV) (all FDR-p ≤ 0.030). Significant diagnosis × cVRF interactions were found for nDGMV and DTI-ALPS (all FDR-p ≤ 0.038). In NMOSD, higher EDSS significantly correlated with lower DTI-ALPS (<i>r</i> = – 0.47, FDR-p = 0.048) and higher SCLV (<i>r</i> = 0.54, FDR-p = 030). Moderation analysis revealed that cVRFs significantly amplified the association between DTI-ALPS and disability (FDR-p = 0.045).</p> Conclusions <p>cVRFs amplify CNS damage and the clinical impact of impaired neurofluid dynamics in NMOSD, suggesting convergent vascular and astrocytic injury.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Cerebrovascular risk factors impact on brain atrophy and DTI-ALPS decrease in neuromyelitis optica spectrum disorder

  • 期刊论文

  • 发表日期：

    2026年5月23日

查看全文
  • Martina Rubin,
  • Paolo Preziosa,
  • Monica Margoni,
  • Loredana Storelli,
  • Elisabetta Pagani,
  • Paola Valsasina,
  • Matteo Albergoni,
  • Lucia Moiola,
  • Massimo Filippi,
  • Maria A. Rocca

摘要

Background

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune astrocytopathy where disability is largely relapse-driven. Cerebrovascular risk factors (cVRFs) may exacerbate astrocytic and small-vessel injury. Therefore, we investigated their impact on MRI damage and disability in NMOSD.

Methods

Twenty-eight aquaporin 4 immunoglobulin G-positive NMOSD patients and 56 age- and sex-matched healthy controls (HC) underwent 3T brain and cervical MRI, cVRF and neurological assessment, including the Expanded Disability Status Scale (EDSS). Brain T2-hyperintense white matter lesion volume (WMLV), normalized global and regional volumes, normal-appearing WM (NAWM) fractional anisotropy (FA) and mean diffusivity (MD), diffusion tensor imaging analysis along the perivascular spaces (DTI-ALPS) index, spinal cord lesion volume (SCLV) and normalized cross-sectional area (nCSA) were quantified.

Results

cVRF were present in 57% of NMOSD and 39% of HC, with smoking being the most frequent (all FDR-p = 0.734). Compared to HC, NMOSD showed significantly higher brain WMLV and SCLV, lower normalized brain (NBV), and deep gray matter volume (nDGMV) (all FDR-p ≤ 0.030). Significant diagnosis × cVRF interactions were found for nDGMV and DTI-ALPS (all FDR-p ≤ 0.038). In NMOSD, higher EDSS significantly correlated with lower DTI-ALPS (r = – 0.47, FDR-p = 0.048) and higher SCLV (r = 0.54, FDR-p = 030). Moderation analysis revealed that cVRFs significantly amplified the association between DTI-ALPS and disability (FDR-p = 0.045).

Conclusions

cVRFs amplify CNS damage and the clinical impact of impaired neurofluid dynamics in NMOSD, suggesting convergent vascular and astrocytic injury.