[P03.113] The Relationship between Spinal Cord Atrophy, Brain Atrophy, and Disability in Multiple Sclerosis

Adam B. Cohen, Boston, MA, Mohit Neema, Ashish Arora, Elisa Dell'Oglio, Brookline, MA, Ralph Benedict, Buffalo, NY, Shahamat Tauhid, Daniel Goldberg-Zimring, Christian Chavarro-Nieto, Antonia Ceccarelli, Joshua Klein, James Stankiewicz, Brookline, MA, Charles Guttmann, Boston, MA, Rohit Bakshi, Brookline, MA

OBJECTIVE: To determine the inter-relationships between spinal cord atrophy, brain atrophy, and disability in patients with multiple sclerosis (MS). BACKGROUND: Although it is known that cervical spinal cord atrophy correlates with disability in MS, it is unknown whether it is the most important determinant when compared to other regions of the CNS. Furthermore, it is not clear to what extent brain and cord atrophy are related. DESIGN/METHODS: 3T MRI of the whole brain and whole spinal cord was obtained in 26 patients with MS, including 23 with relapsing-remitting, one with secondary progressive, one with primary progressive, and one with a clinically isolated syndrome. Brain global gray and white matter volume was segmented with SPM8. Spinal cord contour volume was segmented in whole by a semi-automated method with bins assigned to either the cervical or thoracic regions. All CNS volumes were normalized by the intracranial volume. Brain and cord T2 hyperintense lesions were segmented using a semi-automated edge finding tool. RESULTS: Among all MRI measures, only cervical spinal cord volume correlated with expanded-disability status scale score (r=-0.401; p=0.04). The brain-cord relationships between whole or regional spinal cord volume and compartment-specific or generalized brain volume were generally weak and non-significant. CONCLUSIONS/RELEVANCE: Cervical spinal cord atrophy most strongly correlates with physical disability in MS when accounting for other CNS measures of lesions and atrophy, including thoracic or whole spinal cord volume, and cerebral gray, white or whole brain volume. The weak relationship between spinal cord and brain atrophy suggests that they progress rather independently in patients with MS. Supported by: National Institutes of Health (1R01NS055083-01) and National Multiple Sclerosis Society (RG3705A1; RG3798A2).
Category - MS and Related Diseases - Clinical Science

Wednesday, April 14, 2010 7:30 AM

Poster Session III: Multiple Sclerosis and Related Diseases: MRI Diverse (7:30 AM-12:00 PM)