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Research ArticleAdult Brain
Open Access

Gray Matter Volume Reduction Is Associated with Cognitive Impairment in Neuromyelitis Optica

Q. Wang, N. Zhang, W. Qin, Y. Li, Y. Fu, T. Li, J. Shao, L. Yang, F.-D. Shi and C. Yu
American Journal of Neuroradiology October 2015, 36 (10) 1822-1829; DOI: https://doi.org/10.3174/ajnr.A4403
Q. Wang
aFrom the Department of Radiology and Tianjin Key Laboratory of Functional Imaging (Q.W., N.Z., W.Q., C.Y.)
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N. Zhang
aFrom the Department of Radiology and Tianjin Key Laboratory of Functional Imaging (Q.W., N.Z., W.Q., C.Y.)
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W. Qin
aFrom the Department of Radiology and Tianjin Key Laboratory of Functional Imaging (Q.W., N.Z., W.Q., C.Y.)
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Y. Li
bDepartment of Neurology and Tianjin Neurological Institute (Y.L., Y.F., T.L., J.S., L.Y., F.-D.S.), Tianjin Medical University General Hospital, Tianjin, China
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Y. Fu
bDepartment of Neurology and Tianjin Neurological Institute (Y.L., Y.F., T.L., J.S., L.Y., F.-D.S.), Tianjin Medical University General Hospital, Tianjin, China
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T. Li
bDepartment of Neurology and Tianjin Neurological Institute (Y.L., Y.F., T.L., J.S., L.Y., F.-D.S.), Tianjin Medical University General Hospital, Tianjin, China
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J. Shao
bDepartment of Neurology and Tianjin Neurological Institute (Y.L., Y.F., T.L., J.S., L.Y., F.-D.S.), Tianjin Medical University General Hospital, Tianjin, China
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L. Yang
bDepartment of Neurology and Tianjin Neurological Institute (Y.L., Y.F., T.L., J.S., L.Y., F.-D.S.), Tianjin Medical University General Hospital, Tianjin, China
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F.-D. Shi
bDepartment of Neurology and Tianjin Neurological Institute (Y.L., Y.F., T.L., J.S., L.Y., F.-D.S.), Tianjin Medical University General Hospital, Tianjin, China
cDepartment of Neurology (F.-D.S.), Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
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C. Yu
aFrom the Department of Radiology and Tianjin Key Laboratory of Functional Imaging (Q.W., N.Z., W.Q., C.Y.)
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    Fig 1.

    Brain regions with GMV differences between patients with NMO and healthy controls (P < .05, false discovery rate correction). Blue represents significant GMV reductions in the patients with NMO. L indicates left; R, right.

  • Fig 2.
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    Fig 2.

    Correlations between the GMV and clinical variables in patients with NMO. The left column shows brain regions where the GMV is correlated with EDSS scores (Alphasim correction, P < .05). The right column shows scatter diagrams of these correlations. ITG indicates inferior temporal gyrus; MPFC, medial prefrontal cortex.

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    Fig 3.

    Correlations between the GMV and cognitive scores in patients with NMO. The upper row shows brain regions where the GMV is correlated with cognitive scores (Alphasim correction, P < .05). The middle row shows scatter diagrams of these correlations. The lower row shows brain regions where the GMV is correlated with cognitive scores after further controlling for the brain lesion volume. Immediate recall of Trial 2 (A), long-delay free recall (B), and short-delay free recall (C). MPFC indicates medial prefrontal cortex; R_Th, right thalamus.

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    Fig 4.

    Correlations between the GMV and BLV in patients with NMO (Alphasim correction, P < .05). A, Before removing 2 patients with thalamic and inferior temporal gyrus (ITG) lesions. B, After removing 2 patients with thalamic and ITG lesions.

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    Table 1:

    Demographic and clinical characteristics of the subjectsa

    SubjectsPatients with NMOHCsP Value
    No. of subjects5050NA
    Sex (female/male)42:843:7.779
    Age (yr)47.4 (13.4)49.8 (8.9).294
    Education (yr)11.2 (3.4)12.1 (3.1).192
    NMO-IgG (±)32/18NANA
    Brain lesion volumes (cm3)b3.3 (5.1)NANA
    Onset age (yr)41.6 (14.1)NANA
    Relapsing frequency (times/yr)0.8 (0.7)NANA
    No. of attacks (times)4.5 (5.1)NANA
    Disease duration (yr)6.6 (6.7)NANA
    EDSS score3.8 (2.3)NANA
    • Note:—NA indicates not applicable.

    • ↵a All values are expressed as mean (SD).

    • ↵b Thirty-seven patients had visible brain lesions.

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    Table 2:

    Neuropsychological tests for patients with NMO and healthy controlsa

    Neuropsychological TestsPatients with NMOHCsP Value
    CVLT-II
        IR28.7 (2.2) (n = 44)9.6 (2.5) (n = 45).075
        SDFR11.1 (2.6) (n = 44)11.8 (2.3) (n = 45).176
        SDCR11.0 (2.2) (n = 44)12.0 (2.2) (n = 45).030b
        LDFR10.9 (2.9) (n = 44)12.2 (2.2) (n = 45).017b
        LDCR10.5 (3.1) (n = 44)12.1 (2.2) (n = 45).007b
    PASAT34.4 (12.3) (n = 43)37.6 (7.7) (n = 45).152
    SDMT42.1 (12.2) (n = 39)49.5 (15.1) (n = 45).018b
    WCST8.8 (3.9) (n = 34)10.0 (5.2) (n = 44).245
    COWAT (semantic)17.5 (4.7) (n = 43)19.5 (4.0) (n = 44).035b
    • Note:—CVLT-II indicates California Verbal Learning Test–Second Edition; COWAT, Controlled Oral Word Association Test; IR2, Immediate Recall of Trail 2; LDCR, Long-Delay Cued Recall; LDFR, Long-Delay Free Recall; PASAT, Paced Auditory Serial Addition Test; SDCR, Short-Delay Cued Recall; SDFR, Short-Delay Free Recall; SDMT, Symbol Digit Modalities Test; WCST, Wisconsin Card Sorting Test.

    • ↵a Data are shown as mean (SD).

    • ↵b Significant.

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American Journal of Neuroradiology: 36 (10)
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Q. Wang, N. Zhang, W. Qin, Y. Li, Y. Fu, T. Li, J. Shao, L. Yang, F.-D. Shi, C. Yu
Gray Matter Volume Reduction Is Associated with Cognitive Impairment in Neuromyelitis Optica
American Journal of Neuroradiology Oct 2015, 36 (10) 1822-1829; DOI: 10.3174/ajnr.A4403

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Gray Matter Volume Reduction Is Associated with Cognitive Impairment in Neuromyelitis Optica
Q. Wang, N. Zhang, W. Qin, Y. Li, Y. Fu, T. Li, J. Shao, L. Yang, F.-D. Shi, C. Yu
American Journal of Neuroradiology Oct 2015, 36 (10) 1822-1829; DOI: 10.3174/ajnr.A4403
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