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Hypothalamic lesions in neuromyelitis optica spectrum disorders: exploring a scoring system based on magnetic resonance imaging

Authors
  • Luo, Wenjing1
  • Fang, Ling2
  • Wang, Zhanhang3
  • Liu, Zifeng2
  • Liao, Jinchi1
  • Meng, Zhanao2
  • Shen, Shishi1
  • Liu, Baozhu3
  • Li, Rui1
  • Kermode, Allan G.4, 5
  • Qiu, Wei1
  • 1 The Third Affiliated Hospital of Sun Yat-Sen University, No. 600 Tianhe Road, Guangzhou, Guangdong Province, 510630, China , Guangzhou (China)
  • 2 The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China , Guangzhou (China)
  • 3 GuangDong 999 Brain Hospital, Guangzhou, China , Guangzhou (China)
  • 4 University of Western Australia, Perth, WA, Australia , Perth (Australia)
  • 5 Queen Elizabeth II Medical Centre, Perth, WA, Australia , Perth (Australia)
Type
Published Article
Journal
Japanese Journal of Radiology
Publisher
Springer Singapore
Publication Date
Mar 10, 2021
Volume
39
Issue
7
Pages
659–668
Identifiers
DOI: 10.1007/s11604-021-01104-w
Source
Springer Nature
Keywords
Disciplines
  • Original Article
License
Yellow

Abstract

PurposeWe propose a scoring system for early diagnosis of sleep abnormalities in neuromyelitis optica spectrum disorders (NMOSD) with hypothalamic lesions based on magnetic resonance imaging (MRI).Materials and methodsWe evaluated MRI features of 45 patients with hypothalamic lesions identified from two cohorts. Univariate logistic regression analysis identified factors associated with sleepiness, which were subsequently used to develop a scoring system. Interrater reliability was determined using intraclass correlation coefficient (ICC). Correlations between scores and clinical features were analyzed.ResultsIn total, 48.9% of 45 patients with hypothalamic lesions exhibited sleepiness. The number of involved slices, maximum width/length of hypothalamic lesions, and boundaries extending beyond the hypothalamus were associated with sleepiness (all p < 0.05). The sensitivity and specificity of the scoring system were 68.2% and 87.0%, respectively. The ICC values for the maximum width and length measurement of hypothalamic lesions were 0.82 and 0.81, respectively. Daily sleep time and Epworth sleepiness scale scores were positively correlated with MRI-based scores (p < 0.05, 95% confidence interval (CI) 0.69–0.93 and p < 0.05, 95% CI 0.55–0.88, respectively).ConclusionA scoring system based on MRI features was developed to provide diagnosis of sleepiness in NMOSD with hypothalamic lesions earlier than other measures.

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