Contributions
Abstract: 64
Type: Oral
Abstract Category: Pathology and pathogenesis of MS - Imaging
Introduction: So far little is known about the relationship between dynamic changes of spinal cord volume (SCV) and disease course in multiple sclerosis (MS). We aim at exploring the prognostic value of SCV changes in relapsing-remitting (RR) and secondary progressive (SP) MS patients over 7 years.
Methods: Upper cervical cord volume (length of segment: 35mm, approximately from foramen magnum up to the C2/C3 intervertebral disc) from 1281 high-resolution 3D-T1-weighted MPRAGE scans (acquired at a single 1.5T scanner, TR/TI/TE=2080/1100/3.0 ms; α=15°, 160 slices, resolution: 0.98x0.98x1mm3) of 231 MS patients [180 RRMS (137 women; mean age: 41.4; median EDSS: 2.5), 51 SPMS (27 women; mean age: 55.3; median EDSS: 4.5)] imaged serially over 7 years, were segmented using a novel semi-automatic software (CORDIAL). SCV metrics, the cumulative number of clinical relapses and expanded disability status scale (EDSS) scores were determined per patient per year. Statistical analyses included linear mixed-effect models for between-group differences and the effect of clinical relapses on SCV, as well as for the investigation of correlations between SCV and EDSS.
Results: Overall, SPMS patients had lower SCV than RRMS (mean SCV: 2227mm3 vs. 2398mm3, p< 0.01), however the slope of volume loss over 7 years did not differ between groups (p=0.66). Males exhibited a faster volume loss (p< 0.01). In RRMS the accumulation of clinical relapses (mean annual relapse rate: 0.20) during monitoring time was strongly associated with a faster pace of volume loss (p< 0.05). SCV loss was significantly associated with increasing EDSS scores (p< 0.05), while SPMS showed a faster increase in EDSS with volume decline (p< 0.05) compared to the RRMS.
Conclusions: Spinal cord volume decreases at the same speed in both SPMS and RRMS, while the accumulation of clinical relapses notably affects the speed of SC volume loss for RRMS. The SCV is associated with longitudinal changes of physical disability and SCV loss is a stronger predictor for disability progression in SPMS than RRMS.
Disclosure: C.T. : No conflicts of interest.
S.M. : Travel support from Biogen.
L.G. : Advisory board (Novartis).
S.P. : No conflicts of interest.
N.Y. : No conflicts of interest.
A.M. : No conflicts of interest.
C.P. : No conflicts of interest.
J.W. : CEO of MIAC AG, Basel, Switzerland. In the past he served for advisory boards of Biogen, Genzyme, Novartis and received speaker´s honoraria/travel support from Bayer, Biogen, Novartis and Teva. He has received support from the German Ministery of Science (BMBF), the German Ministery of Economy (BMWi) and the European Union (Horizon2020).
O.B. : No conflicts of interest
T.S. :The current and previous employers of TS have received compensation for his serving on
scientific advisory boards or speaking fees from Novartis, ATI, Sanofi Genzyme, Actelion, Jansen, Teva, Mitsubishi Pharma Europe and Biogen Idec.
LK : Author"s institution (University Hospital Basel) has received in last 3 years and used exclusively for research support: steering committee, advisory board, and consultancy fees (Actelion, Addex, Bayer HealthCare, Biogen Idec, Biotica, Genzyme, Lilly, Merck,Mitsubishi, Novartis, Ono Pharma, Pfizer, Receptos, Sanofi, Santhera, Siemens, Teva, UCB, XenoPort); speaker fees (Bayer HealthCare, Biogen Idec, Merck, Novartis, Sanofi, Teva); support of educational activities (Bayer HealthCare, Biogen, CSL Behring, Genzyme, Merck, Novartis, Sanofi, Teva); royalties (Neurostatus Systems GmbH); grants (Bayer HealthCare, Biogen Idec, European Union, Merck, Novartis, Roche Research Foundation, Swiss MS Society, Swiss National Research Foundation).
WK : No conflicts of interest.
Abstract: 64
Type: Oral
Abstract Category: Pathology and pathogenesis of MS - Imaging
Introduction: So far little is known about the relationship between dynamic changes of spinal cord volume (SCV) and disease course in multiple sclerosis (MS). We aim at exploring the prognostic value of SCV changes in relapsing-remitting (RR) and secondary progressive (SP) MS patients over 7 years.
Methods: Upper cervical cord volume (length of segment: 35mm, approximately from foramen magnum up to the C2/C3 intervertebral disc) from 1281 high-resolution 3D-T1-weighted MPRAGE scans (acquired at a single 1.5T scanner, TR/TI/TE=2080/1100/3.0 ms; α=15°, 160 slices, resolution: 0.98x0.98x1mm3) of 231 MS patients [180 RRMS (137 women; mean age: 41.4; median EDSS: 2.5), 51 SPMS (27 women; mean age: 55.3; median EDSS: 4.5)] imaged serially over 7 years, were segmented using a novel semi-automatic software (CORDIAL). SCV metrics, the cumulative number of clinical relapses and expanded disability status scale (EDSS) scores were determined per patient per year. Statistical analyses included linear mixed-effect models for between-group differences and the effect of clinical relapses on SCV, as well as for the investigation of correlations between SCV and EDSS.
Results: Overall, SPMS patients had lower SCV than RRMS (mean SCV: 2227mm3 vs. 2398mm3, p< 0.01), however the slope of volume loss over 7 years did not differ between groups (p=0.66). Males exhibited a faster volume loss (p< 0.01). In RRMS the accumulation of clinical relapses (mean annual relapse rate: 0.20) during monitoring time was strongly associated with a faster pace of volume loss (p< 0.05). SCV loss was significantly associated with increasing EDSS scores (p< 0.05), while SPMS showed a faster increase in EDSS with volume decline (p< 0.05) compared to the RRMS.
Conclusions: Spinal cord volume decreases at the same speed in both SPMS and RRMS, while the accumulation of clinical relapses notably affects the speed of SC volume loss for RRMS. The SCV is associated with longitudinal changes of physical disability and SCV loss is a stronger predictor for disability progression in SPMS than RRMS.
Disclosure: C.T. : No conflicts of interest.
S.M. : Travel support from Biogen.
L.G. : Advisory board (Novartis).
S.P. : No conflicts of interest.
N.Y. : No conflicts of interest.
A.M. : No conflicts of interest.
C.P. : No conflicts of interest.
J.W. : CEO of MIAC AG, Basel, Switzerland. In the past he served for advisory boards of Biogen, Genzyme, Novartis and received speaker´s honoraria/travel support from Bayer, Biogen, Novartis and Teva. He has received support from the German Ministery of Science (BMBF), the German Ministery of Economy (BMWi) and the European Union (Horizon2020).
O.B. : No conflicts of interest
T.S. :The current and previous employers of TS have received compensation for his serving on
scientific advisory boards or speaking fees from Novartis, ATI, Sanofi Genzyme, Actelion, Jansen, Teva, Mitsubishi Pharma Europe and Biogen Idec.
LK : Author"s institution (University Hospital Basel) has received in last 3 years and used exclusively for research support: steering committee, advisory board, and consultancy fees (Actelion, Addex, Bayer HealthCare, Biogen Idec, Biotica, Genzyme, Lilly, Merck,Mitsubishi, Novartis, Ono Pharma, Pfizer, Receptos, Sanofi, Santhera, Siemens, Teva, UCB, XenoPort); speaker fees (Bayer HealthCare, Biogen Idec, Merck, Novartis, Sanofi, Teva); support of educational activities (Bayer HealthCare, Biogen, CSL Behring, Genzyme, Merck, Novartis, Sanofi, Teva); royalties (Neurostatus Systems GmbH); grants (Bayer HealthCare, Biogen Idec, European Union, Merck, Novartis, Roche Research Foundation, Swiss MS Society, Swiss National Research Foundation).
WK : No conflicts of interest.