Contributions
Abstract: P1057
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Imaging
Background: Myelin water fraction (MWF) can be used as an in-vivo marker of myelin in demyelinating diseases such as multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). A recent study showed that MWF measurements in normal appearing cervical cord tissue were lower in relapsing-remitting MS (RRMS) and NMOSD cohorts compared to healthy controls. Furthermore, MWF decreased over one year in RRMS but not in NMOSD or controls. We investigated the MWF reduction patterns in the normal appearing brainstem tissue of the same populations.
Objective: To determine if the patterns of MWF differences observed in normal appearing cervical cord tissue are also demonstrated in non-lesional brainstem regions of the same RRMS and NMOSD cohorts at baseline and over one year.
Methods: Multi-component driven equilibrium single pulse observation of T1/T2 (mcDESPOT) data were acquired in 11 RRMS patients (mean age: 42 (range: 28-62)), 7 anti-aquaporin-4 seropositive NMOSD patients (48 (27-76)), and 13 age-matched healthy controls (49 (26-76)), using a 3T scanner with 1.7x1.7x1.7 mm voxels at baseline and at 12 months. Images were registered using FSL-FLIRT. The brainstem regions of interest (ROIs) including medulla, midbrain and pons were manually drawn on three slices per scan, excluding any lesions. Mean MWF was calculated within each ROI. Parametric statistics were used to compare cohorts at baseline and over one year.
Results: CROSS-SECTIONAL: There was no significant difference in normal appearing brainstem MWF between controls (medulla MWF at baseline = 0.17 ± 0.02), RRMS (0.16 ± 0.02) and NMOSD (0.17 ± 0.01). Similar results were seen for midbrain and pons. LONGITUDINAL: There was no significant difference in normal appearing brainstem MWF changes over one year between controls (medulla one-year percentage change in MWF = 2.83% ± 8.30%), RRMS (-1.59% ± 7.78%) and NMOSD (-0.74% ± 7.09%).
Conclusion: In contrast to myelin differences seen in the normal appearing cervical spinal cords in the same cohorts, similar differences were not detectable in the brainstem. This suggests that pathological changes occurring in the spinal cord are at least partially independent of brain and brainstem changes.
Disclosure: Anthony Traboulsee is a consultant for Novartis, Genzyme, Roche and a principal investigator on clinical trials with Biogen, Genzyme, Roche, and Chugai.
Shannon Kolind has acted as a consultant/scientific advisor for Genzyme, Vertex, and Roche.
Jacqueline Palace is partly funded by highly specialized services to run a National congenital myasthenia service and a neuromyelitis service. She has received support for scientific meetings and honorariums for advisory work from Merck Serono, Biogen Idec, Novartis, Teva, Chugai Phama, Alexion and Bayer Schering, and unrestricted grants from Merck Serono, Novartis, Biogen Idec and Bayer Schering. Her hospital trust receives funds for her role as clinical lead for the RSS, and she has received grants from the MS society and Guthy Jackson Foundation for unrelated research studies.
Anna Combes has received partial PhD funding from Janssen.
Robert Carruthers is a site principal investigator for studies funded by MedImmune, Teva, and Guthy Jackson. He has received speaking fees for unbranded lectures from Biogen, Genzyme, and Teva. He has received consulting fees for Novartis, EMD Serono, and Genzyme.
David Li has received research funding from the Canadian Institute of Health Research and Multiple Sclerosis Society of Canada. He is the Director of the UBC MS/MRI Research Group, which has been contracted to perform central analysis of MRI scans for therapeutic trials with Novartis, Perceptives, Roche and Sanofi-Aventis. The UBC MS/MRI Research Group has also received grant support for investigator-initiated independent studies from Genzyme, Merck-Serono, Novartis and Roche. He has acted as a consultant to Vertex Pharmaceuticals and served on the Data and Safety Advisory Board for Opexa Therapeutics and Scientific Advisory Boards for Adelphi Group, Novartis and Roche. He has also given lectures, which have been supported by non-restricted education grants from Novartis and Biogen.
Lucy Matthews has nothing to disclose.
Katrina McMullen has nothing to disclose.
Lisa Eunyoung Lee has nothing to disclose.
Abstract: P1057
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Imaging
Background: Myelin water fraction (MWF) can be used as an in-vivo marker of myelin in demyelinating diseases such as multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). A recent study showed that MWF measurements in normal appearing cervical cord tissue were lower in relapsing-remitting MS (RRMS) and NMOSD cohorts compared to healthy controls. Furthermore, MWF decreased over one year in RRMS but not in NMOSD or controls. We investigated the MWF reduction patterns in the normal appearing brainstem tissue of the same populations.
Objective: To determine if the patterns of MWF differences observed in normal appearing cervical cord tissue are also demonstrated in non-lesional brainstem regions of the same RRMS and NMOSD cohorts at baseline and over one year.
Methods: Multi-component driven equilibrium single pulse observation of T1/T2 (mcDESPOT) data were acquired in 11 RRMS patients (mean age: 42 (range: 28-62)), 7 anti-aquaporin-4 seropositive NMOSD patients (48 (27-76)), and 13 age-matched healthy controls (49 (26-76)), using a 3T scanner with 1.7x1.7x1.7 mm voxels at baseline and at 12 months. Images were registered using FSL-FLIRT. The brainstem regions of interest (ROIs) including medulla, midbrain and pons were manually drawn on three slices per scan, excluding any lesions. Mean MWF was calculated within each ROI. Parametric statistics were used to compare cohorts at baseline and over one year.
Results: CROSS-SECTIONAL: There was no significant difference in normal appearing brainstem MWF between controls (medulla MWF at baseline = 0.17 ± 0.02), RRMS (0.16 ± 0.02) and NMOSD (0.17 ± 0.01). Similar results were seen for midbrain and pons. LONGITUDINAL: There was no significant difference in normal appearing brainstem MWF changes over one year between controls (medulla one-year percentage change in MWF = 2.83% ± 8.30%), RRMS (-1.59% ± 7.78%) and NMOSD (-0.74% ± 7.09%).
Conclusion: In contrast to myelin differences seen in the normal appearing cervical spinal cords in the same cohorts, similar differences were not detectable in the brainstem. This suggests that pathological changes occurring in the spinal cord are at least partially independent of brain and brainstem changes.
Disclosure: Anthony Traboulsee is a consultant for Novartis, Genzyme, Roche and a principal investigator on clinical trials with Biogen, Genzyme, Roche, and Chugai.
Shannon Kolind has acted as a consultant/scientific advisor for Genzyme, Vertex, and Roche.
Jacqueline Palace is partly funded by highly specialized services to run a National congenital myasthenia service and a neuromyelitis service. She has received support for scientific meetings and honorariums for advisory work from Merck Serono, Biogen Idec, Novartis, Teva, Chugai Phama, Alexion and Bayer Schering, and unrestricted grants from Merck Serono, Novartis, Biogen Idec and Bayer Schering. Her hospital trust receives funds for her role as clinical lead for the RSS, and she has received grants from the MS society and Guthy Jackson Foundation for unrelated research studies.
Anna Combes has received partial PhD funding from Janssen.
Robert Carruthers is a site principal investigator for studies funded by MedImmune, Teva, and Guthy Jackson. He has received speaking fees for unbranded lectures from Biogen, Genzyme, and Teva. He has received consulting fees for Novartis, EMD Serono, and Genzyme.
David Li has received research funding from the Canadian Institute of Health Research and Multiple Sclerosis Society of Canada. He is the Director of the UBC MS/MRI Research Group, which has been contracted to perform central analysis of MRI scans for therapeutic trials with Novartis, Perceptives, Roche and Sanofi-Aventis. The UBC MS/MRI Research Group has also received grant support for investigator-initiated independent studies from Genzyme, Merck-Serono, Novartis and Roche. He has acted as a consultant to Vertex Pharmaceuticals and served on the Data and Safety Advisory Board for Opexa Therapeutics and Scientific Advisory Boards for Adelphi Group, Novartis and Roche. He has also given lectures, which have been supported by non-restricted education grants from Novartis and Biogen.
Lucy Matthews has nothing to disclose.
Katrina McMullen has nothing to disclose.
Lisa Eunyoung Lee has nothing to disclose.