Spatiotemporal Subtypes of Brain and Spinal Cord Atrophy in Neuromyelitis Optica Spectrum Disorders and Multiple Sclerosis

Motivation: The atrophy subtypes of neuromyelitis optica spectrum disorders (NMOSD) and multiple sclerosis (MS) remain elusive. Goal(s): Identify shared and distinct atrophy subtypes in NMOSD and MS, using neuroimaging to explore their clinical significance and potential implications for tailored treatment strategies. Approach: 3D T1-weighted image derived structural measurements were used in a Subtype and Stage Inference model, to identify distinct brain and spinal cord atrophy subtypes of NMOSD and MS. Results: Both shared and distinct spatiotemporal brain and spinal cord atrophy subtypes were identified in AQP4+ NMOSD and MS, with distinct clinical and MRI features. Impact: These novel imaging subtypes in NMOSD and MS can help interpret disease heterogeneity, develop stratified management, and assess prognosis.