Spinal cord atrophy in anterior‐posterior direction reflects impairment in multiple sclerosis

• Published in: Acta neurologica Scandinavica Vol. 136; no. 4; pp. 330 - 337
• Main Authors: Lundell, H., Svolgaard, O., Dogonowski, A.‐M., Romme Christensen, J., Selleberg, F., Soelberg Sørensen, P., Blinkenberg, M., Siebner, H. R., Garde, E.
• Format: Journal Article
• Language: English
• Published: Denmark Hindawi Limited 01.10.2017
• Subjects: Adult; Aged; Atrophy; Atrophy - diagnostic imaging; Atrophy - pathology; Brain - diagnostic imaging; Brain - pathology; Disability Evaluation; Female; Humans; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Middle Aged; Multiple sclerosis; Multiple Sclerosis - diagnostic imaging; Multiple Sclerosis - pathology; Multiple Sclerosis, Chronic Progressive - diagnostic imaging; Multiple Sclerosis, Chronic Progressive - pathology; Multiple Sclerosis, Relapsing-Remitting - diagnostic imaging; Multiple Sclerosis, Relapsing-Remitting - pathology; Neurodegeneration; Neuroimaging; Spinal cord; Spinal Cord - diagnostic imaging; Spinal Cord - pathology; atrophy; magnetic resonance imaging; spinal cord; multiple sclerosis
• ISSN: 0001-6314; 1600-0404
• DOI: 10.1111/ane.12729

Objective To investigate how atrophy is distributed over the cross section of the upper cervical spinal cord and how this relates to functional impairment in multiple sclerosis (MS). Methods We analysed the structural brain MRI scans of 54 patients with relapsing‐remitting MS (n=22), primary progressive MS (n=9), secondary progressive MS (n=23) and 23 age‐ and sex‐matched healthy controls. We measured the cross‐sectional area (CSA), left‐right width (LRW) and anterior‐posterior width (APW) of the spinal cord at the segmental level C2. We tested for a nonparametric linear relationship between these atrophy measures and clinical impairments as reflected by the Expanded Disability Status Scale (EDSS) and Multiple Sclerosis Impairment Scale (MSIS). Results In patients with MS, CSA and APW but not LRW were reduced compared to healthy controls (P<.02) and showed significant correlations with EDSS, MSIS and specific MSIS subscores. Conclusion In patients with MS, atrophy of the upper cervical cord is most evident in the antero‐posterior direction. As APW of the cervical cord can be readily derived from standard structural MRI of the brain, APW constitutes a clinically useful neuroimaging marker of disease‐related neurodegeneration in MS.