Two-year study of cervical cord volume and myelin water in primary progressive multiple sclerosis

2010 ◽  
Vol 16 (6) ◽  
pp. 670-677 ◽  
Author(s):  
C. Laule ◽  
IM Vavasour ◽  
Y. Zhao ◽  
AL Traboulsee ◽  
J. Oger ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Glatiramer Acetate ◽  
Grey Matter ◽  
Interquartile Range ◽  
Cervical Cord ◽  
Controlled Clinical Trial ◽  
Grey Matter Volume ◽  
Primary Progressive Multiple Sclerosis ◽  
Primary Progressive ◽  
Matter Volume

Background: Spinal cord involvement in multiple sclerosis (MS) is common and an important element in disability. Previous studies demonstrated smaller cervical cord area at the C2 level in MS compared to controls, and a decrease in cord area over 12 months, most marked in primary progressive MS (PPMS). A subset of subjects participating in a multicentre, double-blind, placebo-controlled clinical trial evaluating the efficacy of glatiramer acetate in PPMS (PROMiSe trial) were followed for 2 years. Methods: 24 PPMS subjects, randomized to placebo ( n = 9) and glatiramer acetate ( n = 15), and 24 matched controls were studied. Cervical cord volume (CCV) at C2—3 was determined using a 3D inversion recovery (IR)-prepared spoiled-gradient echo sequence. Myelin water fraction (MWF) at C2—3 was obtained using a 32-echo IR-prepared relaxation sequence. Scans were repeated at baseline, years 1 and 2. Results: Baseline CCV was significantly smaller for PPMS than controls [median (interquartile range) 951 (829—1043) vs. 1072 (1040—1129) mm3, p = 0.0004] and MWF trended to be lower in PPMS cord [median (interquartile range) 0.225 (0.187—0.267) vs. 0.253 (0.235—0.266), p = 0.12]. Baseline CCV correlated with baseline Expanded Disability Status Scale, disease duration, brain white and grey matter volume. In PPMS, CCV was significantly decreased at year 1 (—0.83%, p = 0.04) and year 2 (—1.65%, p = 0.02). Baseline MWF correlated with baseline CCV and brain white and grey matter volume. MWF was significantly decreased from baseline for PPMS at year 2 (—10.5%, p = 0.01). Treatment effect was not detected on change in CCV nor MWF. Conclusions: Metrics at the level of the cord, including volume and MWF at C2—3, were lower in PPMS than controls and changed over 2 years only in PPMS.

scholarly journals Cortical involvement determines impairment 30 years after a clinically isolated syndrome

Brain ◽  
2021 ◽  
Author(s):  
Lukas Haider ◽  
Ferran Prados ◽  
Karen Chung ◽  
Olivia Goodkin ◽  
Baris Kanber ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Grey Matter ◽  
Disease Duration ◽  
Magnetization Transfer ◽  
Clinically Isolated Syndrome ◽  
Cervical Cord ◽  
Grey Matter Volume ◽  
Cortical Lesions ◽  
Matter Volume

Abstract Many studies report an overlap of MRI and clinical findings between patients with relapsing-remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS), which in part is reflective of inclusion of subjects with variable disease duration and short periods of follow-up. To overcome these limitations, we examined the differences between RRMS and SPMS and the relationship between MRI measures and clinical outcomes 30 years after first presentation with clinically isolated syndrome suggestive of multiple sclerosis. Sixty-three patients were studied 30 years after their initial presentation with a clinically isolated syndrome; only 14% received a disease modifying treatment at any time point. Twenty-seven patients developed RRMS, 15 SPMS and 21 experienced no further neurological events; these groups were comparable in terms of age and disease duration. Clinical assessment included the Expanded Disability Status Scale, 9-Hole Peg Test and Timed 25-Foot Walk and the Brief International Cognitive Assessment For Multiple Sclerosis. All subjects underwent a comprehensive MRI protocol at 3 T measuring brain white and grey matter (lesions, volumes and magnetization transfer ratio) and cervical cord involvement. Linear regression models were used to estimate age- and gender-adjusted group differences between clinical phenotypes after 30 years, and stepwise selection to determine associations between a large sets of MRI predictor variables and physical and cognitive outcome measures. At the 30-year follow-up, the greatest differences in MRI measures between SPMS and RRMS were the number of cortical lesions, which were higher in SPMS (the presence of cortical lesions had 100% sensitivity and 88% specificity), and grey matter volume, which was lower in SPMS. Across all subjects, cortical lesions, grey matter volume and cervical cord volume explained 60% of the variance of the Expanded Disability Status Scale; cortical lesions alone explained 43%. Grey matter volume, cortical lesions and gender explained 43% of the variance of Timed 25-Foot Walk. Reduced cortical magnetization transfer ratios emerged as the only significant explanatory variable for the symbol digit modality test and explained 52% of its variance. Cortical involvement, both in terms of lesions and atrophy, appears to be the main correlate of progressive disease and disability in a cohort of individuals with very long follow-up and homogeneous disease duration, indicating that this should be the target of therapeutic interventions.

Imaging primary progressive multiple sclerosis: the contribution of structural, metabolic, and functional MRI techniques

2004 ◽  
Vol 10 (3_suppl) ◽  
pp. S36-S45 ◽  
Author(s):  
Massimo Filippi ◽  
Marco Rovaris ◽  
Maria A Rocca
Keyword(s):  
Multiple Sclerosis ◽  
Functional Mri ◽  
Progressive Multiple Sclerosis ◽  
Neurological Deficits ◽  
Cervical Cord ◽  
Primary Progressive Multiple Sclerosis ◽  
Primary Progressive ◽  
Mri Scans ◽  
Functional Consequences ◽  
Magnetic Resonance Imaging Mri

Patients with primary progressive multiple sclerosis (PPMS) typically experience a progressive disease course from onset, leading to the accumulation of severe neurological disability. This is in contrast with the observation that the burden and activity of lesions on conventional magnetic resonance imaging (MRI) scans of the brain are much lower in patients with PPMS than in those with other less disabling forms of the disease. Studies with structural and functional MRI techniques are providing relevant contributions to the understanding of the mechanisms underlying the accumulatio n of irreversible neurological deficits in patients with PPMS. The results of these studies underpin that the main factors possibly explaining the clinical/MRI discrepancy observed in patients with PPMS include the presence of a diffuse tissue damage that is beyond the resolution of conventional imaging, the extent of cervical cord damage, and the impairment of the adaptive capacity of the cortex to limit the functional consequences of subcortical pathology.

Whole brain and grey matter volume of Japanese patients with multiple sclerosis

2017 ◽  
Vol 306 ◽  
pp. 68-75 ◽  
Author(s):  
Tetsuya Akaishi ◽  
Ichiro Nakashima ◽  
Shunji Mugikura ◽  
Masashi Aoki ◽  
Kazuo Fujihara
Keyword(s):  
Multiple Sclerosis ◽  
Grey Matter ◽  
Japanese Patients ◽  
Grey Matter Volume ◽  
Whole Brain ◽  
Matter Volume

scholarly journals Usefulness of two-dimensional measurements for the evaluation of brain volume and disability in multiple sclerosis

2022 ◽  
Vol 8 (1) ◽  
pp. 205521732110707
Author(s):  
Satori Ajitomi ◽  
Juichi Fujimori ◽  
Ichiro Nakashima
Keyword(s):  
Multiple Sclerosis ◽  
Processing Speed ◽  
Lateral Ventricle ◽  
Grey Matter ◽  
Brain Volume ◽  
Grey Matter Volume ◽  
Two Dimensional ◽  
Whole Brain ◽  
Brain Volumes ◽  
Matter Volume

Background Two-dimensional (2D) measures have been proposed as potential proxies for whole-brain volume in multiple sclerosis (MS). Objective To verify whether 2D measurements by routine MRI are useful in predicting brain volume or disability in MS. Methods In this cross-sectional analysis, eighty-five consecutive Japanese MS patients—relapsing-remitting MS (81%) and progressive MS (19%)—underwent 1.5 Tesla T1-weighted 3D MRI examinations to measure whole-brain and grey matter volume. 2D measurements, namely, third ventricle width, lateral ventricle width (LVW), brain width, bicaudate ratio, and corpus callosum index (CCI), were obtained from each scan. Correlations between 2D measurements and 3D measurements, the Expanded Disability Status Scale (EDSS), or processing speed were analysed. Results The third and lateral ventricle widths were well-correlated with the whole-brain volume ( p < 0.0001), grey matter volume ( p < 0.0001), and EDSS scores ( p = 0.0001, p = .0004, respectively).The least squares regression model revealed that 78% of the variation in whole-brain volume could be explained using five explanatory variables, namely, LVW, CCI, age, sex, and disease duration. By contrast, the partial correlation coefficient excluding the effect of age showed that the CCI was significantly correlated with the EDSS and processing speed ( p < 0.0001). Conclusion Ventricle width correlated well with brain volumes, while the CCI correlated well with age-independent (i.e. disease-induced) disability.

scholarly journals Ongoing microstructural changes in the cervical cord underpin disability progression in early primary progressive multiple sclerosis

2020 ◽  
Vol 27 (1) ◽  
pp. 28-38 ◽  
Author(s):  
Rosa Cortese ◽  
Carmen Tur ◽  
Ferran Prados ◽  
Torben Schneider ◽  
Baris Kanber ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Brain Mri ◽  
Progressive Multiple Sclerosis ◽  
Cervical Cord ◽  
Primary Progressive Multiple Sclerosis ◽  
Disability Progression ◽  
Mixed Effect ◽  
Primary Progressive ◽  
Over Time

Background: Pathology in the spinal cord of patients with primary progressive multiple sclerosis (PPMS) contributes to disability progression. We previously reported abnormal Q-space imaging (QSI)-derived indices in the spinal cord at baseline in patients with early PPMS, suggesting early neurodegeneration. Objective: The aim was to investigate whether changes in spinal cord QSI over 3 years in the same cohort are associated with disability progression and if baseline QSI metrics predict clinical outcome. Methods: Twenty-three PPMS patients and 23 healthy controls recruited at baseline were invited for follow-up cervical cord 3T magnetic resonance imaging (MRI) and clinical assessment after 1 year and 3 years. Cord cross-sectional area (CSA) and QSI measures were obtained, together with standard brain MRI measures. Mixed-effect models assessed MRI changes over time and their association with clinical changes. Linear regression identified baseline MRI indices associated with disability at 3 years. Results: Over time, patients deteriorated clinically and showed an increase in cord QSI indices of perpendicular diffusivity that was associated with disability worsening, independently of the decrease in CSA. Higher perpendicular diffusivity and lower CSA at baseline predicted worse disability at 3 years. Conclusion: Increasing spinal cord perpendicular diffusivity may indicate ongoing neurodegeneration, which underpins disability progression in PPMS, independently of the development of spinal cord atrophy.

Genes associated with grey matter volume reduction in multiple sclerosis

2021 ◽  
Author(s):  
Jie Sun ◽  
Yingying Xie ◽  
Qiuhui Wang ◽  
Junlin Shen ◽  
Wen Qin ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Grey Matter ◽  
Volume Reduction ◽  
Grey Matter Volume ◽  
Matter Volume
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