Contributions
Abstract: P603
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Biomarkers
Background: Multiple sclerosis (MS) is characterized by severe cervical cord atrophy.
Aims. We evaluated whether cord atrophy development over time was different across phenotypes by analysing a large, multicentre dataset of MS patients acquired at 8 European sites.
Methods: 3D T1-weighted cervical cord scans were acquired from 152 healthy controls (HC) and 350 MS patients (35 clinically isolated syndromes [CIS], 144 relapsing-remitting MS [RRMS], 89 secondary-progressive MS [SPMS], 45 benign MS [BMS] and 37 primary-progressive MS [PPMS]). Follow-up scans were obtained from 131 subjects (median follow-up time=1.05 years, range=0.5-2.1 years). Whole-cervical cord cross-sectional area (CSA) was assessed using the active surface method. CSA at baseline and its changes over time were compared between HC and MS patients and among clinical phenotypes using ANOVA models (adjusted for age, sex and site) and paired t tests.
Results: Baseline CSA was lower in MS patients vs HC (p< 0.001), in PPMS vs HC and CIS (p< 0.001), in RRMS vs CIS (p< 0.001), and in SPMS vs PPMS and RRMS (p=0.04 and p< 0.001, respectively). Cord CSA change over time was +0.04% in HC (p=0.8) and -1.05% in MS (p=0.001), with a significant time x group effect (p=0.04). When the phenotypes were analyzed separately, significant cord tissue loss was found in RRMS (CSA change=-1.5%, p=0.003) and PPMS (CSA change=-1.96%, p=0.05), but not in the remaining phenotypes.
Conclusions: Apart from CIS, significant cervical cord atrophy was found in all MS phenotypes. The cord tissue loss we observed over time was mainly driven from PPMS and RRMS patients.
Study Supported by: Mohammad Aboul-Wafa has been supported by the ECTRIMS-MAGNIMS Fellowship in Magnetic Resonance Imaging.
Disclosure: Drs Preziosa, Aboul-Wafa, Valsasina, Kearney, Matthews, Gallo, Bisecco, and Bellenberg have nothing to disclose.
Dr Rocca received speakers honoraria from Biogen Idec, Novartis and ExceMed and receives research support from the Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla.
Dr Barkhof serves on the editorial boards of Brain, Neurology, Neuroradiology, Multiple Sclerosis Journal and Radiology, and serves as a consultant for Bayer-Schering Pharma, Sanofi-Aventis, Genzyme, Biogen-Idec, Teva, Novartis, Roche, Synthon BV, and Jansen Research.
Dr Vrenken has received funding for collaborative research projects from Pfizer, Novartis, and Merck-Serono, and a speaker honorarium from Novartis; all funds paid directly to his institution.
Dr Rovira serves on scientific advisory boards for Biogen Idec, Novartis, Genzyme, and OLEA Medical, and on the editorial board of the American Journal of Neuroradiology and Neuroradiology, has received speaker honoraria from Bayer, Genzyme, Sanofi-Aventis, Bracco, Merck-Serono, Teva Pharmaceutical Industries Ltd, OLEA Medical, Stendhal, Novartis, and Biogen Idec, and has research agreements with Siemens AG.
Dr Montalban has received speaking honoraria and travel expenses for participation in scientific meetings, has been a steering committee member of clinical trials or participated in advisory boards of clinical trials in the past years with Actelion, Almirall, Bayer, Biogen, Genzyme, Merck, Novartis, Octapharma, Receptos, Roche, Sanofi-Genzyme, Teva, and Trophos.
Dr Ciccarelli received a grant from Novartis, Biogen-Idec, GE, and EPSRC; receives personal fees from Novartis and Genzyme.
Dr Palace has received support for scientific meetings and honoraria for advisory work from Merck Serono, Biogen Idec, Novartis, Teva, Chugai Pharma 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 for unrelated research studies.
Dr Gass has received honoraria for lecturing, travel expenses for attending meetings, and financial support for research from BayerSchering, Biogen, MerckSerono, Novartis.
Dr Eisele has received travel expenses from Bayer Health Care.
Dr Lukas has received consulting fees or speaking fees from Biogen Idec, Bayer Schering Germany, Teva, Genzyme, Sanofi-Aventis and Novartis, as well as grant support from Bayer Schering Germany, Novartis and Merck Serono.
Prof. Comi has received consulting fees for participating on advisory boards from Novartis, Teva Pharmaceutical Ind. Ltd, Sanofi, Genzyme, Merck Serono, Bayer, Actelion and honorarium for speaking activities for Novartis, Teva Pharmaceutical Ind. Ltd, Sanofi, Genzyme, Merck Serono, Bayer, Biogen, Excemed.
Prof. Filippi is Editor-in-Chief of the Journal of Neurology; serves on scientific advisory boards for Teva Pharmaceutical Industries; has received compensation for consulting services and/or speaking activities from Biogen Idec, Excemed, Novartis, and Teva Pharmaceutical Industries; and receives research support from Biogen Idec, Teva Pharmaceutical Industries, Novartis, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla, Cure PSP, Alzheimer´s Drug Discovery Foundation (ADDF), the Jacques and Gloria Gossweiler Foundation (Switzerland), and ARiSLA (Fondazione Italiana di Ricerca per la SLA).
Abstract: P603
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Biomarkers
Background: Multiple sclerosis (MS) is characterized by severe cervical cord atrophy.
Aims. We evaluated whether cord atrophy development over time was different across phenotypes by analysing a large, multicentre dataset of MS patients acquired at 8 European sites.
Methods: 3D T1-weighted cervical cord scans were acquired from 152 healthy controls (HC) and 350 MS patients (35 clinically isolated syndromes [CIS], 144 relapsing-remitting MS [RRMS], 89 secondary-progressive MS [SPMS], 45 benign MS [BMS] and 37 primary-progressive MS [PPMS]). Follow-up scans were obtained from 131 subjects (median follow-up time=1.05 years, range=0.5-2.1 years). Whole-cervical cord cross-sectional area (CSA) was assessed using the active surface method. CSA at baseline and its changes over time were compared between HC and MS patients and among clinical phenotypes using ANOVA models (adjusted for age, sex and site) and paired t tests.
Results: Baseline CSA was lower in MS patients vs HC (p< 0.001), in PPMS vs HC and CIS (p< 0.001), in RRMS vs CIS (p< 0.001), and in SPMS vs PPMS and RRMS (p=0.04 and p< 0.001, respectively). Cord CSA change over time was +0.04% in HC (p=0.8) and -1.05% in MS (p=0.001), with a significant time x group effect (p=0.04). When the phenotypes were analyzed separately, significant cord tissue loss was found in RRMS (CSA change=-1.5%, p=0.003) and PPMS (CSA change=-1.96%, p=0.05), but not in the remaining phenotypes.
Conclusions: Apart from CIS, significant cervical cord atrophy was found in all MS phenotypes. The cord tissue loss we observed over time was mainly driven from PPMS and RRMS patients.
Study Supported by: Mohammad Aboul-Wafa has been supported by the ECTRIMS-MAGNIMS Fellowship in Magnetic Resonance Imaging.
Disclosure: Drs Preziosa, Aboul-Wafa, Valsasina, Kearney, Matthews, Gallo, Bisecco, and Bellenberg have nothing to disclose.
Dr Rocca received speakers honoraria from Biogen Idec, Novartis and ExceMed and receives research support from the Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla.
Dr Barkhof serves on the editorial boards of Brain, Neurology, Neuroradiology, Multiple Sclerosis Journal and Radiology, and serves as a consultant for Bayer-Schering Pharma, Sanofi-Aventis, Genzyme, Biogen-Idec, Teva, Novartis, Roche, Synthon BV, and Jansen Research.
Dr Vrenken has received funding for collaborative research projects from Pfizer, Novartis, and Merck-Serono, and a speaker honorarium from Novartis; all funds paid directly to his institution.
Dr Rovira serves on scientific advisory boards for Biogen Idec, Novartis, Genzyme, and OLEA Medical, and on the editorial board of the American Journal of Neuroradiology and Neuroradiology, has received speaker honoraria from Bayer, Genzyme, Sanofi-Aventis, Bracco, Merck-Serono, Teva Pharmaceutical Industries Ltd, OLEA Medical, Stendhal, Novartis, and Biogen Idec, and has research agreements with Siemens AG.
Dr Montalban has received speaking honoraria and travel expenses for participation in scientific meetings, has been a steering committee member of clinical trials or participated in advisory boards of clinical trials in the past years with Actelion, Almirall, Bayer, Biogen, Genzyme, Merck, Novartis, Octapharma, Receptos, Roche, Sanofi-Genzyme, Teva, and Trophos.
Dr Ciccarelli received a grant from Novartis, Biogen-Idec, GE, and EPSRC; receives personal fees from Novartis and Genzyme.
Dr Palace has received support for scientific meetings and honoraria for advisory work from Merck Serono, Biogen Idec, Novartis, Teva, Chugai Pharma 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 for unrelated research studies.
Dr Gass has received honoraria for lecturing, travel expenses for attending meetings, and financial support for research from BayerSchering, Biogen, MerckSerono, Novartis.
Dr Eisele has received travel expenses from Bayer Health Care.
Dr Lukas has received consulting fees or speaking fees from Biogen Idec, Bayer Schering Germany, Teva, Genzyme, Sanofi-Aventis and Novartis, as well as grant support from Bayer Schering Germany, Novartis and Merck Serono.
Prof. Comi has received consulting fees for participating on advisory boards from Novartis, Teva Pharmaceutical Ind. Ltd, Sanofi, Genzyme, Merck Serono, Bayer, Actelion and honorarium for speaking activities for Novartis, Teva Pharmaceutical Ind. Ltd, Sanofi, Genzyme, Merck Serono, Bayer, Biogen, Excemed.
Prof. Filippi is Editor-in-Chief of the Journal of Neurology; serves on scientific advisory boards for Teva Pharmaceutical Industries; has received compensation for consulting services and/or speaking activities from Biogen Idec, Excemed, Novartis, and Teva Pharmaceutical Industries; and receives research support from Biogen Idec, Teva Pharmaceutical Industries, Novartis, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla, Cure PSP, Alzheimer´s Drug Discovery Foundation (ADDF), the Jacques and Gloria Gossweiler Foundation (Switzerland), and ARiSLA (Fondazione Italiana di Ricerca per la SLA).