Chu-Yu Lee1, Jessie M Huisinga2, In-Young Choi3, Sharon G Lynch4, Phil Lee5. 1. Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA. 2. Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA; Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA. 3. Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA; Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA; Department of Molecular & Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, USA. 4. Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA. 5. Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA; Department of Radiology, University of Kansas Medical Center, Kansas City, KS, USA. Electronic address: plee2@kumc.edu.
Abstract
PURPOSE: Longer latency of postural response in multiple sclerosis (MS) may be linked to imbalance and increased likelihood of falls. It may be caused by the compromised microstructural integrity in the spinal cord, as evidenced by slowed somatosensory conduction in the spinal cord. Thus, the purpose of this study is to investigate the correlation between latency of postural responses and microstructural integrity of the cervical spinal cord, the region particularly related to the disease severity in MS, using diffusion tensor imaging (DTI) metrics. METHODS: Seventeen persons with MS with mild-to-moderate disease severity were enrolled in this study. Postural response latencies of each patient were measured using electromyography of the tibialis anterior muscle (TA) and gastrocnemius muscle (GN) in response to surface perturbations. Cervical spinal cord DTI images were obtained from each patient. DTI mean, radial, axial diffusivity, and fractional anisotropy (FA) were measured between segments C4 and C6. Correlations of DTI metrics with postural response latencies, expanded disability status scale (EDSS) scores, and 25-foot walk (T25FW) were assessed using the Spearman's rank correlation coefficient at α = 0.05. RESULTS: Lower FA was significantly correlated with longer latencies measured on right TA in response to forward postural perturbations (r = -0.51, p = .04). DTI metrics showed no significant correlations with EDSS scores (r = -0.06-0.09, p = .73-0.95) or T25FW (r = -0.1-0.14, p = .6-0.94). DTI metrics showed no significant differences between subjects with and without spinal cord lesions (p = .2-0.7). CONCLUSIONS: Our results showed a significant correlation between lower FA in the cervical spinal cord and longer latencies measured on right TA in response to forward postural perturbations in persons with MS, suggesting that impaired cervical spinal cord microstructure assessed by DTI may be associated with the delayed postural responses.
PURPOSE: Longer latency of postural response in multiple sclerosis (MS) may be linked to imbalance and increased likelihood of falls. It may be caused by the compromised microstructural integrity in the spinal cord, as evidenced by slowed somatosensory conduction in the spinal cord. Thus, the purpose of this study is to investigate the correlation between latency of postural responses and microstructural integrity of the cervical spinal cord, the region particularly related to the disease severity in MS, using diffusion tensor imaging (DTI) metrics. METHODS: Seventeen persons with MS with mild-to-moderate disease severity were enrolled in this study. Postural response latencies of each patient were measured using electromyography of the tibialis anterior muscle (TA) and gastrocnemius muscle (GN) in response to surface perturbations. Cervical spinal cord DTI images were obtained from each patient. DTI mean, radial, axial diffusivity, and fractional anisotropy (FA) were measured between segments C4 and C6. Correlations of DTI metrics with postural response latencies, expanded disability status scale (EDSS) scores, and 25-foot walk (T25FW) were assessed using the Spearman's rank correlation coefficient at α = 0.05. RESULTS: Lower FA was significantly correlated with longer latencies measured on right TA in response to forward postural perturbations (r = -0.51, p = .04). DTI metrics showed no significant correlations with EDSS scores (r = -0.06-0.09, p = .73-0.95) or T25FW (r = -0.1-0.14, p = .6-0.94). DTI metrics showed no significant differences between subjects with and without spinal cord lesions (p = .2-0.7). CONCLUSIONS: Our results showed a significant correlation between lower FA in the cervical spinal cord and longer latencies measured on right TA in response to forward postural perturbations in persons with MS, suggesting that impaired cervical spinal cord microstructure assessed by DTI may be associated with the delayed postural responses.
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