A multicenter assessment of cervical cord atrophy among MS clinical phenotypes
Citation Manager Formats
Make Comment
See Comments
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Objective: In this multicenter study, a new semiautomatic method for segmenting the cervical cord from C2 to C5 was used to investigate the correlation between cord atrophy and clinical disability in a large sample of patients with multiple sclerosis (MS).
Methods: T2 and 3-dimensional T1-weighted cervical cord scans and dual-echo brain scans were acquired from 143 healthy controls, 22 patients with clinically isolated syndromes (CIS), 101 patients with relapsing-remitting MS (RRMS), 79 patients with secondary progressive MS (SPMS), 58 patients with benign MS (BMS), and 75 patients with primary progressive MS (PPMS) in 3 European centers. Normalized cervical cord cross-sectional area (CSAn) was measured by an active surface cord model. Between-group comparisons were performed using linear mixed-effect models. A nonparametric kernel estimator was used to obtain smoothed plots of CSA along the cervical cord.
Results: Cord CSAn was significantly lower in PPMS vs healthy controls, BMS vs RRMS, SPMS vs BMS, and RRMS. From C2 to C5, a net separation and definition of the plots of patients with BMS, PPMS, and SPMS was seen with respect to those of the other study groups. CSAn was correlated with Expanded Disability Status Scale (r = −0.49, p < 0.0001), with a differential effect among disease clinical phenotypes: no association in either CIS or in BMS; association in RRMS (r = −0.30, p = 0.001), SPMS (r = −0.34, p = 0.001), and PPMS (r = −0.27, p = 0.01).
Conclusions: Cervical cord atrophy provides a relevant and useful marker for the characterization of clinical heterogeneity of patients with MS. The stability of this measure among different centers supports its use as potential outcome measure to monitor disease progression in multicenter trials.
Footnotes
Study funding: Supported in part by the Ministry of Science, Republic of Serbia (175031).
-
Supplemental data at www.neurology.org
-
- AS
- active surface
- BMS
- benign multiple sclerosis
- CIS
- clinically isolated syndrome
- CSA
- cross-sectional area
- CSAn
- normalized cervical cord cross-sectional area
- DE
- dual-echo
- EDSS
- Expanded Disability Status Scale
- ICCSA
- intracranial cross-sectional area
- LV
- lesion volume
- MS
- multiple sclerosis
- PPMS
- primary progressive multiple sclerosis
- RRMS
- relapsing-remitting multiple sclerosis
- SPMS
- secondary progressive multiple sclerosis
- TSE
- turbo spin echo.
- Received December 22, 2010.
- Accepted February 25, 2011.
- Copyright © 2011 by AAN Enterprises, Inc.
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)
Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here
Purchase
Individual access to articles is available through the Add to Cart option on the article page. Access for 1 day (from the computer you are currently using) is US$ 39.00. Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means. The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use. Distributing copies (electronic or otherwise) of the article is not allowed.
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Dr. Fabricio Ferreira de Oliveira and Dr. Alan Cronemberger Andrade
► Watch
Topics Discussed
Alert Me
Recommended articles
-
Article
Clinically relevant cranio-caudal patterns of cervical cord atrophy evolution in MSMaria A. Rocca, Paola Valsasina, Alessandro Meani et al.Neurology, October 14, 2019 -
Article
Cervical cord lesion load is associated with disability independently from atrophy in MSHugh Kearney, Daniel R. Altmann, Rebecca S. Samson et al.Neurology, December 24, 2014 -
Views and Reviews
MRI features of benign multiple sclerosisToward a new definition of this disease phenotypeM. Rovaris, F. Barkhof, M. Calabrese et al.Neurology, May 11, 2009 -
Articles
Primary and transitional progressive MSA clinical and MRI cross-sectional studyV.L. Stevenson, D.H. Miller, M. Rovaris et al.Neurology, March 01, 1999