Association Between Thoracic Spinal Cord Gray Matter Atrophy and Disability in Multiple Sclerosis

• DOI: 10.1001/jamaneurol.2015.0993
• Publication Date: 2015-06-08T12:33:25Z
• Authors: Regina Schlaeger; Nico Papinutto; Alyssa H. Zhu; Iryna V. Lobach; Carolyn J. Bevan; Monica Bucci; Antonella Castellano; Jeffrey M. Gelfand; Jennifer S. Graves; Ari J. Green; Kesshi M. Jordan; Anisha Keshavan; Valentina Panara; William A. Stern; H.-Christian von ...; Emmanuelle Waubant; Douglas S. Goodin; Bruce A. C. Cree; Stephen L. Hauser; Roland G. Henry
• Keywords: Adult; Male; Multiple Sclerosis; Clinical Sciences; 610; Clinical sciences; Neurodegenerative; Autoimmune Disease; Thoracic Vertebrae; Disability Evaluation; 03 medical and health sciences; 0302 clinical medicine; Clinical Research; Humans; Gray Matter; 10. No inequality; Aged; Neurology & Neurosurgery; Biomedical and Clinical Sciences; Neurosciences; Middle Aged; Magnetic Resonance Imaging; Brain Disorders; 3. Good health; Cross-Sectional Studies; Spinal Cord; Neurological; Disease Progression; Biomedical Imaging; Cognitive Sciences; Female; Atrophy

IMPORTANCEIn multiple sclerosis (MS), upper cervical cord gray matter (GM) atrophy correlates more strongly with disability than does brain or white (WM) atrophy.The corresponding relationships in the thoracic are unknown owing to technical difficulties assessing GM and WM compartments by conventional magnetic resonance imaging techniques.OBJECTIVES To investigate associations between MS disease type lower areas using phase-sensitive inversion recovery at 3 T, as well compare these those obtained levels.DESIGN, SETTING, AND PARTICIPANTS Between July 2013 March 2014, a total of 142 patients (aged 25-75 years; 86 women) 20 healthy control individuals were included this cross-sectional observational study conducted an academic university hospital.MAIN OUTCOMES MEASURES Total (TCAs), areas, disc levels C2/C3, C3/C4, T8/9, T9/10.Area differences groups assessed, age sex covariates. RESULTSPatients relapsing (RMS) had smaller did ageand sex-matched (mean [coefficient variation (COV)]: 0.98 mm 2 [9.2%];P = .003at T8/T9 0.93 [8.0%];P .01at T9/T10); however, there no significant either area TCA.Patients progressive showed [COV]: 1.02 [10.6%];P < .001at 1.37 [13.2%];P T9/T10) TCAs 3.66 [9.0%];P 3.04 [7.2%];P .004at compared RMS.All measurements (GM, WM, TCA) inversely correlated Expanded Disability Status Scale score.Thoracic limb function.In multivariable models (which also T2 lesion number, volumes, T1 fluid-attenuated loads, age, sex, duration), strongest correlation score followed volume.CONCLUSIONS RELEVANCE Thoracic can be detected vivo absence RMS.This is pronounced RMS function.Our results indicate that remarkable present and, therefore, may reflect widespread degeneration.