Charidimos Tsagkas1, Stefano Magon1, Laura Gaetano1, Simon Pezold1, Yvonne Naegelin1, Michael Amann1, Christoph Stippich1, Philippe Cattin1, Jens Wuerfel1, Oliver Bieri1, Till Sprenger1, Ludwig Kappos1, Katrin Parmar2. 1. From the Department of Neurology (C.T., S.M., L.G., Y.N., M.A., T.S., L.K., K.P.), Division of Diagnostic and Interventional Neuroradiology, Department of Radiology (M.A., C.S.), and Division of Radiological Physics, Department of Radiology (O.B.), University Hospital Basel, University of Basel; Medical Image Analysis Center (MIAC AG) (C.T., S.M., L.G., M.A., J.W.), Basel; Department of Biomedical Engineering (S.P., P.C.), University of Basel, Switzerland; and Department of Neurology (T.S.), DKD HELIOS Klinik Wiesbaden, Germany. 2. From the Department of Neurology (C.T., S.M., L.G., Y.N., M.A., T.S., L.K., K.P.), Division of Diagnostic and Interventional Neuroradiology, Department of Radiology (M.A., C.S.), and Division of Radiological Physics, Department of Radiology (O.B.), University Hospital Basel, University of Basel; Medical Image Analysis Center (MIAC AG) (C.T., S.M., L.G., M.A., J.W.), Basel; Department of Biomedical Engineering (S.P., P.C.), University of Basel, Switzerland; and Department of Neurology (T.S.), DKD HELIOS Klinik Wiesbaden, Germany. katrin.parmar@usb.ch.
Abstract
OBJECTIVE: Cross-sectional studies have shown that spinal cord volume (SCV) loss is related to disease severity in multiple sclerosis (MS). However, long-term data are lacking. Our aim was to evaluate SCV loss as a biomarker of disease progression in comparison to other MRI measurements in a large cohort of patients with relapse-onset MS with 6-year follow-up. METHODS: The upper cervical SCV, the total brain volume, and the brain T2 lesion volume were measured annually in 231 patients with MS (180 relapsing-remitting [RRMS] and 51 secondary progressive [SPMS]) over 6 years on 3-dimensional, T1-weighted, magnetization-prepared rapid-acquisition gradient echo images. Expanded Disability Status Scale (EDSS) score and relapses were recorded at every follow-up. RESULTS: Patients with SPMS had lower baseline SCV (p < 0.01) but no accelerated SCV loss compared to those with RRMS. Clinical relapses were found to predict SCV loss over time (p < 0.05) in RRMS. Furthermore, SCV loss, but not total brain volume and T2 lesion volume, was a strong predictor of EDSS score worsening over time (p < 0.05). The mean annual rate of SCV loss was the strongest MRI predictor for the mean annual EDSS score change of both RRMS and SPMS separately, while correlating stronger in SPMS. Every 1% increase of the annual SCV loss rate was associated with an extra 28% risk increase of disease progression in the following year in both groups. CONCLUSION: SCV loss over time relates to the number of clinical relapses in RRMS, but overall does not differ between RRMS and SPMS. SCV proved to be a strong predictor of physical disability and disease progression, indicating that SCV may be a suitable marker for monitoring disease activity and severity.
OBJECTIVE: Cross-sectional studies have shown that spinal cord volume (SCV) loss is related to disease severity in multiple sclerosis (MS). However, long-term data are lacking. Our aim was to evaluate SCV loss as a biomarker of disease progression in comparison to other MRI measurements in a large cohort of patients with relapse-onset MS with 6-year follow-up. METHODS: The upper cervical SCV, the total brain volume, and the brain T2 lesion volume were measured annually in 231 patients with MS (180 relapsing-remitting [RRMS] and 51 secondary progressive [SPMS]) over 6 years on 3-dimensional, T1-weighted, magnetization-prepared rapid-acquisition gradient echo images. Expanded Disability Status Scale (EDSS) score and relapses were recorded at every follow-up. RESULTS:Patients with SPMS had lower baseline SCV (p < 0.01) but no accelerated SCV loss compared to those with RRMS. Clinical relapses were found to predict SCV loss over time (p < 0.05) in RRMS. Furthermore, SCV loss, but not total brain volume and T2 lesion volume, was a strong predictor of EDSS score worsening over time (p < 0.05). The mean annual rate of SCV loss was the strongest MRI predictor for the mean annual EDSS score change of both RRMS and SPMS separately, while correlating stronger in SPMS. Every 1% increase of the annual SCV loss rate was associated with an extra 28% risk increase of disease progression in the following year in both groups. CONCLUSION:SCV loss over time relates to the number of clinical relapses in RRMS, but overall does not differ between RRMS and SPMS. SCV proved to be a strong predictor of physical disability and disease progression, indicating that SCV may be a suitable marker for monitoring disease activity and severity.
Authors: Antonio Barreiro-González; Maria T Sanz; Sara Carratalà-Boscà; Francisco Pérez-Miralles; Carmen Alcalá; Enrique España-Gregori; Bonaventura Casanova Journal: Acta Neurol Belg Date: 2020-10-12 Impact factor: 2.396
Authors: Pierre Cabaraux; Sunil K Agrawal; Huaying Cai; Rocco Salvatore Calabro; Carlo Casali; Loic Damm; Sarah Doss; Christophe Habas; Anja K E Horn; Winfried Ilg; Elan D Louis; Hiroshi Mitoma; Vito Monaco; Maria Petracca; Alberto Ranavolo; Ashwini K Rao; Serena Ruggieri; Tommaso Schirinzi; Mariano Serrao; Susanna Summa; Michael Strupp; Olivia Surgent; Matthis Synofzik; Shuai Tao; Hiroo Terasi; Diego Torres-Russotto; Brittany Travers; Jaimie A Roper; Mario Manto Journal: Cerebellum Date: 2022-04-12 Impact factor: 3.847
Authors: Caila B Vaughn; Dejan Jakimovski; Katelyn S Kavak; Murali Ramanathan; Ralph H B Benedict; Robert Zivadinov; Bianca Weinstock-Guttman Journal: Nat Rev Neurol Date: 2019-06 Impact factor: 42.937
Authors: Charidimos Tsagkas; M Mallar Chakravarty; Laura Gaetano; Yvonne Naegelin; Michael Amann; Katrin Parmar; Athina Papadopoulou; Jens Wuerfel; Ludwig Kappos; Till Sprenger; Stefano Magon Journal: Hum Brain Mapp Date: 2020-02-17 Impact factor: 5.038