Low myo-inositol indicating astrocytic damage in a case series of neuromyelitis optica

Olga Ciccarelli, David L Thomas, Enrico De Vita, Claudia A M Wheeler-Kingshott, Carolina Kachramanoglou, Raj Kapoor, Siobhan Leary, Lucy Matthews, Jacqueline Palace, Declan Chard, David H Miller, Ahmed T Toosy, Alan J Thompson

Research output: Contribution to journalArticlepeer-review

44 Citations (Scopus)


Astrocytic necrosis is a prominent pathological feature of neuromyelitis optica (NMO) lesions and is clinically relevant. We report 5 NMO-related cases, all with longitudinally extensive lesions in the upper cervical cord, who underwent cervical cord (1) H-magnetic resonance spectroscopy. Lower myo-inositol/creatine values, suggesting astrocytic damage, were consistently found within the NMO lesions when compared with healthy controls and patients with multiple sclerosis (MS), who showed at least 1 demyelinating lesion at the same cord level. Therefore, the in vivo quantification of myo-inositol may distinguish NMO from MS. This is an important step toward developing imaging markers for clinical trials in NMO.

Original languageEnglish
Pages (from-to)301-5
Number of pages5
JournalAnnals of Neurology
Issue number2
Publication statusPublished - Aug 2013


  • Adult
  • Astrocytes/metabolism
  • Biomarkers
  • Cervical Vertebrae/pathology
  • Diagnosis, Differential
  • Female
  • Humans
  • Inositol/deficiency
  • Male
  • Middle Aged
  • Multiple Sclerosis/diagnosis
  • Neuromyelitis Optica/diagnosis
  • Spinal Cord/metabolism


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