Article Text

other Versions

PDF
Research paper
Cervical spinal cord volume loss is related to clinical disability progression in multiple sclerosis
  1. Carsten Lukas1,
  2. Dirk L Knol2,
  3. Madeleine H Sombekke3,
  4. Barbara Bellenberg1,
  5. Horst K Hahn4,
  6. Veronica Popescu5,
  7. Katrin Weier6,
  8. Ernst W Radue7,
  9. Achim Gass7,
  10. Ludwig Kappos7,
  11. Yvonne Naegelin7,
  12. Bernard M J Uitdehaag3,
  13. Jeroen J G Geurts5,8,
  14. Frederik Barkhof5,
  15. Hugo Vrenken5,9
  1. 1Department of Diagnostic and Interventional Radiology and Nuclear Medicine, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
  2. 2Department of Epidemiology and Biostatistics, VU University Medical Center & Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
  3. 3Department of Neurology, MS Center Amsterdam, VU University Medical Center & Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
  4. 4Fraunhofer MEVIS, Institute for Medical Image Computing, Bremen, Germany,
  5. 5Department of Radiology, Nuclear Medicine and PET Research, MS Center Amsterdam, VU University Medical Center & Neuroscience Campus Amsterdam, Amsterdam, The Netherlands.
  6. 6Department of Neurology, University Hospital Basel, Basel, Switzerland.
  7. 7Medical Image Analysis Center (MIAC), University Hospital Basel, Basel, Switzerland.
  8. 8Department of Anatomy and Neurosciences, section of Clinical Neuroscience, VU University Medical Center & Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
  9. 9Department of Physics and Medical Technology, MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
  1. Correspondence to Dr Carsten Lukas, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, St. Josef Hospital, Ruhr University Bochum, Gudrunstr. 56, Bochum 44791, Germany; Carsten.Lukas{at}rub.de

Abstract

Objective To examine the temporal evolution of spinal cord (SC) atrophy in multiple sclerosis (MS), and its association with clinical progression in a large MS cohort.

Methods A total of 352 patients from two centres with MS (relapsing remitting MS (RRMS): 256, secondary progressive MS (SPMS): 73, primary progressive MS (PPMS): 23) were included. Clinical and MRI parameters were obtained at baseline, after 12 months and 24 months of follow-up. In addition to conventional brain and SC MRI parameters, the annualised percentage brain volume change and the annualised percentage upper cervical cord cross-sectional area change (aUCCA) were quantified. Main outcome measure was disease progression, defined by expanded disability status scale increase after 24 months.

Results UCCA was lower in SPMS and PPMS compared with RRMS for all time points. aUCCA over 24 months was highest in patients with SPMS (−2.2% per year) and was significantly higher in patients with disease progression (−2.3% per year) than in stable patients (−1.2% per year; p=0.003), while annualised percentage brain volume change did not differ between subtypes (RRMS: −0.42% per year; SPMS −0.6% per year; PPMS: −0.46% per year) nor between progressive and stable patients (p=0.055). Baseline UCCA and aUCCA over 24 months were found to be relevant contributors of expanded disability status scale at month-24, while baseline UCCA as well as number of SC segments involved by lesions at baseline but not aUCCA were relevant contributors of disease progression.

Conclusions SC MRI parameters including baseline UCCA and SC lesions were significant MRI predictors of disease progression. Progressive 24-month upper SC atrophy occurred in all MS subtypes, and was faster in patients exhibiting disease progression at month-24.

  • Multiple Sclerosis
  • MRI

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.