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Brain size and white matter content of cerebrospinal tracts determine the upper cervical cord area: evidence from structural brain MRI

  • Diagnostic Neuroradiology
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Abstract

Introduction

Measurement of the upper cervical cord area (UCCA) from brain MRI may be an effective way to quantify spinal cord involvement in neurological disorders such as multiple sclerosis. However, knowledge on the determinants of UCCA in healthy controls (HCs) is limited.

Methods

In two cohorts of 133 and 285 HCs, we studied the influence of different demographic, body-related, and brain-related parameters on UCCA by simple and partial correlation analyses as well as by voxel-based morphometry (VBM) across both cerebral gray matter (GM) and white matter (WM).

Results

First, we confirmed the known but moderate effect of age on UCCA in the older cohort. Second, we studied the correlation of UCCA with sex, body height, and total intracranial volume (TIV). TIV was the only variable that correlated significantly with UCCA after correction for the other variables. Third, we studied the correlation of UCCA with brain-related parameters. Brain volume correlated stronger with UCCA than TIV. Both volumes of the brain tissue compartments GM and WM correlated with UCCA significantly. WM volume explained variance of UCCA after correction for GM volume, whilst the opposite was not observed. Correspondingly, VBM did not yield any brain region, whose GM content correlated significantly with UCCA, whilst cerebral WM content of cerebrospinal tracts strongly correlated with UCCA. This latter effect increased along a craniocaudal gradient.

Conclusion

UCCA is mainly determined by brain volume as well as by WM content of cerebrospinal tracts.

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Acknowledgments

MM and VB received support from Merck Serono (Project: The Upper Cervical Cord Area Determined From Cranial MRI as a Marker of Disease Severity in Multiple Sclerosis). Further, MM received support from the German Ministry for Education and Research (BMBF) (German Competence Network Multiple Sclerosis, KKNMS; 01GI1307B).

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany

    Christina Engl, Paul Schmidt, Milan Arsic, Christine C. Boucard, Viola Biberacher, Thorleif Etgen, Sabine Nunnemann & Mark Mühlau

  2. TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany

    Christina Engl, Milan Arsic, Christine C. Boucard, Viola Biberacher, Sabine Nunnemann & Mark Mühlau

  3. Department of Statistics, Ludwig-Maximilians-University München, Munich, Germany

    Paul Schmidt

  4. Department of Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany

    Michael Röttinger

  5. Münchner Institut für Neuroradiologie, Munich, Germany

    Michael Röttinger

  6. Department of Neurology, Klinikum Traunstein, Traunstein, Germany

    Thorleif Etgen

  7. Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany

    Nikolaos Koutsouleris & Eva M. Meisenzahl

  8. Department of Radiology, Ludwig-Maximilians-Universität, Munich, Germany

    Maximilian Reiser

Authors
  1. Christina Engl
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  2. Paul Schmidt
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  3. Milan Arsic
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  4. Christine C. Boucard
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  5. Viola Biberacher
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  6. Michael Röttinger
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  7. Thorleif Etgen
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  8. Sabine Nunnemann
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  9. Nikolaos Koutsouleris
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  10. Maximilian Reiser
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  11. Eva M. Meisenzahl
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  12. Mark Mühlau
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Corresponding author

Correspondence to Mark Mühlau.

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Engl, C., Schmidt, P., Arsic, M. et al. Brain size and white matter content of cerebrospinal tracts determine the upper cervical cord area: evidence from structural brain MRI. Neuroradiology 55, 963–970 (2013). https://doi.org/10.1007/s00234-013-1204-3

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  • DOI: https://doi.org/10.1007/s00234-013-1204-3

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