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

Omid Mirmosayyeb; Mohammad Yazdan Panah; Elham Moases Ghaffary; Saeed Vaheb; Hamed Ghoshouni; Vahid Shaygannejad; Nandor K Pinter

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

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

Authors

Omid Mirmosayyeb¹, Mohammad Yazdan Panah², Elham Moases Ghaffary³, Saeed Vaheb⁴, Hamed Ghoshouni⁴, Vahid Shaygannejad⁴, Nandor K Pinter⁵

Affiliations

¹ Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High St., Buffalo, NY, 14203, USA. omidmirm@buffalo.edu.
² Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran.
³ Pharmacy School, University of Missouri-Kansas City, Kansas City, MO, USA.
⁴ Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
⁵ Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA.

PMID: 39680165
DOI: 10.1007/s00415-024-12827-x

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.

Publication types

Systematic Review
Meta-Analysis
Review

MeSH terms

Biomarkers
Brain / diagnostic imaging
Brain / pathology
Humans
Magnetic Resonance Imaging* / standards
Multiple Sclerosis* / diagnostic imaging
Multiple Sclerosis* / pathology
Neuromyelitis Optica* / diagnostic imaging
Neuromyelitis Optica* / pathology

Substances

Biomarkers