{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T09:38:01Z","timestamp":1784367481818,"version":"3.55.0"},"reference-count":36,"publisher":"SAGE Publications","issue":"14","license":[{"start":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T00:00:00Z","timestamp":1660521600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Due to lack of biomarkers, antibody-negative patients with features of neuromyelitis optica spectrum disorders (NMOSD) are among the most challenging to diagnose and treat. Using unsupervised clustering, we recently identified \u2018MS-like\u2019, \u2018spinal MS-like\u2019, \u2018classic NMOSD-like\u2019 and \u2018NMOSD-like with brain involvement\u2019 subgroups in this cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>We used magnetic resonance spectroscopy (MRS) to examine differences in the level of key metabolites in the spinal cord between the four identified subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Twenty-five relapsing antibody-negative patients with NMOSD features classified by the unsupervised algorithm to one of the subgroups underwent a prospective cervical spinal cord MRS. Spectra from 16 patients fulfilled quality criteria and were included in the analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Total N-acetylaspartate (tNAA), but not total choline (tCho) or myo-inositol (Ins), was significantly different between the four subgroups ( p\u2009=\u20090.03). In particular, tNAA was 47.8% lower in the \u2018MS-like\u2019 subgroup as compared with the \u2018classic NMOSD-like\u2019 subgroup ( p\u2009=\u20090.02). While we found a negative overall correlation between tNAA and disability score ( r\u2009=\u2009\u20130.514, p\u2009=\u20090.04) in the whole cohort, the disability score did not differ significantly between the subgroups to explain subgroup differences in tNAA level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Significant differences in the cervical spinal cord tNAA measurements confirm that the previously identified clinico-radiologic subgroups contain patients with distinct underlying disease processes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585221115304","type":"journal-article","created":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T01:39:40Z","timestamp":1660613980000},"page":"2221-2230","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Relapsing antibody-negative patients with features of neuromyelitis optica spectrum disorders: Differences in\n                    <i>N<\/i>\n                    -acetylaspartate level in the cervical spinal cord indicate distinct underlying processes"],"prefix":"10.1177","volume":"28","author":[{"given":"Bartosz","family":"Kossowski","sequence":"first","affiliation":[{"name":"Laboratory of Brain Imaging, Neurobiology Center, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yazhuo","family":"Kong","sequence":"additional","affiliation":[{"name":"Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"El\u017cbieta","family":"Klimiec-Moskal","sequence":"additional","affiliation":[{"name":"Department of Neurology, Jagiellonian University Medical College, Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uzay","family":"Emir","sequence":"additional","affiliation":[{"name":"Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Palace","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurology, Nuffield Department of Clinical Neurosciences, University of Oxford, Headley Way, OX3 9DU Oxford, UK"},{"name":"Department of Clinical Neurology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maciej","family":"Jury\u0144czyk","sequence":"additional","affiliation":[{"name":"Laboratory of Brain Imaging, Neurobiology Center, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Pasteura 3 Street, 02-098 Warsaw, Poland"},{"name":"Laboratory of Brain Imaging, Neurobiology Center, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland; Department of Clinical Neurology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,8,15]]},"reference":[{"key":"bibr1-13524585221115304","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(07)70216-8"},{"key":"bibr2-13524585221115304","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2013.5857"},{"key":"bibr3-13524585221115304","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000101"},{"key":"bibr4-13524585221115304","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-015-7952-8"},{"key":"bibr5-13524585221115304","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-021-10619-1"},{"key":"bibr6-13524585221115304","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.68.5.627"},{"issue":"2","key":"bibr7-13524585221115304","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1002\/ana.23909","volume":"74","author":"Ciccarelli O","year":"2013","journal-title":"Ann 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