Magnetization Transfer MRI measurements of Cervical Spinal Cord abnormalities in patients with Neuromyelitis Optica

Objective: Neuromyelitis optica (NMO) is an inflammatory and demyelinating disease of central nervous system that preferentially affects the optic nerve and spinal cord. NMO has long been thought of as a rare and severe variant of multiple sclerosis (MS), however, clinical, immunological and pathological characteristics that distinguish it from MS are now recognized [1]. As NMO involves recurrent and aggressive attacks of blindness and paralysis, unlike the attacks in MS, it is crucial to diagnose NMO in the early stages in order to especially provide the proper treatment [2]. However, current diagnostic criteria in routine practice using conventional T1(T1w) and T2-weighted (T2w) images are not sensitive to early degenerative changes in NMO. Recent studies using diffusion tensor imaging have shown abnormality in normal appearing tissues of brain and spinal cord [3,4]. However, normal appearing tissue damage in cervical spinal cord has not been widely investigated due to technical limitations although understanding pathological mechanism in the cervical spinal cord is crucial in research of NMO. The goal of this research is to apply magnetization transfer-weighted (MTw) imaging for assessing the pathological mechanism of normal appearing cervical spinal cord tissue damage in patients with NMO.