{
  "abstract": "Background Differences in brain atrophy rates between patients with aquaporin-4 IgG-positive neuromyelitis optica spectrum disorder (AQP4Ab+NMOSD) and healthy controls (HCs), as well as the impact of biologic agents (BIO) on brain atrophy, have not been fully examined.Methods In total, 72 patients with AQP4Ab+NMOSD identified at Chiba University Hospital or in the Berlin Registry of Neuroimmunological Entities (Chiba, 63; Berlin, 9) and 52 age-matched and sex-matched HCs (Chiba, 47; Berlin, 5) were included. Only patients without relapses between the baseline and follow-up MRI scans were included. Regional brain volumes were normalised to the intracranial volume. Patients who continuously used BIOs or non-BIO preventive treatments between the two MRI scans were assigned to the BIO or non-BIO subgroups, respectively. We applied a longitudinal combined association test to correct for MRI scanner differences.Results Patient age and the interval between MRI scans did not differ between the groups. The NMOSD group exhibited a lower whole-brain volume than the HC group at follow-up (p<0.001) and a significantly higher whole-brain atrophy rate (p=0.009). Patients with smaller subcortical grey matter (SGM) volumes at follow-up MRI exhibited greater clinical disability (ρ = −0.27, p=0.022). In the BIO subgroup, early initiation of treatment (p=0.013) and a higher relative duration of BIO exposure (p=0.028) were associated with lower annualised SGM atrophy rates.Conclusions This study suggested progressive silent brain atrophy in patients with AQP4Ab+NMOSD and that early BIO initiation might prevent the progression of brain atrophy.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan"
      ],
      "name": "Hiroki Masuda"
    },
    {
      "affiliations": [
        "Experimental and Clinical Research Center (ECRC), A Cooperation Between Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin, Berlin, Germany",
        "Neuroscience Clinical Research Center (NCRC), Charité - Universitätsmedizin Berlin, Berlin, Germany"
      ],
      "name": "Lina Anderhalten"
    },
    {
      "affiliations": [
        "Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan"
      ],
      "name": "Masahiro Mori"
    },
    {
      "affiliations": [
        "Department of Pediatrics, Chiba University, Chiba, Chiba, Japan",
        "Department of Pediatrics, International University of Health and Welfare Narita Hospital, Narita, Japan"
      ],
      "name": "Tadashi Shiohama"
    },
    {
      "affiliations": [
        "Center for Evolutionary Cognitive Sciences, The University of Tokyo, Bunkyo, Japan",
        "Department of Radiology, National Center of Neurology and Psychiatry, Kodaira, Japan"
      ],
      "name": "Norihide Maikusa"
    },
    {
      "affiliations": [
        "Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan"
      ],
      "name": "Shigeki Hirano"
    },
    {
      "affiliations": [
        "Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan"
      ],
      "name": "Akiyuki Uzawa"
    },
    {
      "affiliations": [
        "Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan",
        "Department of Neurology, Chiba Rosai Hospital, Chiba, Japan"
      ],
      "name": "Mayumi Muto"
    },
    {
      "affiliations": [
        "Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan",
        "Department of Neurology, Eastern Chiba Medical Center, Togane, Japan"
      ],
      "name": "Ryohei Ohtani"
    },
    {
      "affiliations": [
        "Department of Neurology, Eastern Chiba Medical Center, Togane, Japan"
      ],
      "name": "Tomohiko Uchida"
    },
    {
      "affiliations": [
        "Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan"
      ],
      "name": "Reiji Aoki"
    },
    {
      "affiliations": [
        "Research Center for Child Mental Development, Chiba University, Chiba, Japan"
      ],
      "name": "Hitomi Kitagawa"
    },
    {
      "affiliations": [
        "Chiba University Research Center for Child Mental Development, Chiba, Japan"
      ],
      "name": "Yoshiyuki Hirano"
    },
    {
      "affiliations": [
        "Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan",
        "Experimental and Clinical Research Center (ECRC), A Cooperation Between Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin, Berlin, Germany",
        "Neuroscience Clinical Research Center (NCRC), Charité - Universitätsmedizin Berlin, Berlin, Germany",
        "Department of Pediatrics, Chiba University, Chiba, Chiba, Japan",
        "Department of Pediatrics, International University of Health and Welfare Narita Hospital, Narita, Japan",
        "Center for Evolutionary Cognitive Sciences, The University of Tokyo, Bunkyo, Japan",
        "Department of Radiology, National Center of Neurology and Psychiatry, Kodaira, Japan",
        "Department of Neurology, Chiba Rosai Hospital, Chiba, Japan",
        "Department of Neurology, Eastern Chiba Medical Center, Togane, Japan",
        "Research Center for Child Mental Development, Chiba University, Chiba, Japan",
        "Chiba University Research Center for Child Mental Development, Chiba, Japan"
      ],
      "name": "Japanese Alzheimer’s Disease Neuroimaging Initiative (J-ADNI)"
    },
    {
      "affiliations": [
        "Experimental and Clinical Research Center (ECRC), A Cooperation Between Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin, Berlin, Germany",
        "Neuroscience Clinical Research Center (NCRC), Charité - Universitätsmedizin Berlin, Berlin, Germany"
      ],
      "name": "Friedemann Paul"
    },
    {
      "affiliations": [
        "Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan"
      ],
      "name": "Satoshi Kuwabara"
    }
  ],
  "title": "Biologic therapy and brain atrophy in neuromyelitis optica: a Japanese–German longitudinal MRI study",
  "uid": "6b558cf6-feb7-5a7f-99f7-74f9d5cd109b"
}