Abstract #4: Global vs. Regional Spinal Cord Atrophy in Multiple Sclerosis

Abstract

Objective To assess whole and regional spinal cord atrophy in patients with multiple sclerosis (MS) using 3T MRI. Background Spinal cord damage is common in MS and provides a unique and clinically relevant means to monitor disease progression and therapeutic effects. Whereas regional spinal cord atrophy has been studied extensively in MS, whole spinal cord atrophy has not been previously assessed. Design/Methods Whole spinal cord 3 mm thick T2-weighted axial fast spin-echo MRI images were obtained at 3T on 34 patients with MS [26 women and 8 men; 26 relapsing–remitting, 2 clinically isolated syndrome, 4 secondary progressive, 2 primary progressive; Expanded Disability Status Scale (EDSS) (mean ± SD) 1.95 ± 1.72, range 0–6.5] and 15 age-matched normal controls [11 women and 4 men]. The global and regional (cervical, C2–3, and thoracic) cord volumes were determined using a semi-automated tool and were normalized by the segment length and intracranial volume. Spinal cord lesions were also determined using a semi-automated edge finding tool. Results Whole cord, C2–3, cervical, and thoracic volumes were lower in progressive vs. relapsing patients or normal controls (all p Conclusions The established method of estimating spinal cord atrophy, C2–3 cross-sectional volume, provides a useful surrogate of overall global or regional spinal cord atrophy. Spinal cord atrophy is most common in progressive forms of MS and is related to neurologic disability. Support This study was supported by grants from the National Institutes of Health ( 1R01NS055083-01 ) and the National Multiple Sclerosis Society ( RG3705A1 ; RG3798A2 ).