Contributions
Abstract: P579
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - 21 Imaging
Objective: To explore significance of spinal cord (SC) pathology in terms of volume, focal lesions and diffuse abnormalities in multiple sclerosis (MS) patients with different levels of disability and disease duration.
Background: SC involvement is common in MS and contributes importantly to disability in progressive disease. The relationship of SC pathology and disability in early and benign MS remains less clear.
Methods: Relapse-remitting and secondary progressive MS patients were selected retrospectively from a large group of over 1000 MS patients examined with SC MRI between January and May 2016. We compared spinal cord volume (SCV) in three groups of patients according to disease duration [0-5; 5-15 and >15 years(y)]. In each group, patients with EDSS >3.0 and ≤3.0 were compared. To eliminate confounding effects of sex, age and disease duration (DD), we matched patients by these parameters. The matching resulted in following group pairs: 1.DD 0-5y (n=76, 26 men); 2.DD 5-15y (n=388, 80 men); 3.DD >15y (n=160, 22 men). SCV was measured as a sum of SC areas from 21 slices centered at intervertebral disk C3/4 on axial 3D-T2w-FatSat sequence acquired at 3T scanner by using an in-house developed semiautomatic method. Types of SC involvement were assessed by neuroradiologist and neurologist, resulting in 4 categories: 1.normally appearing SC, 2.focal lesions, 3.diffuse abnormalities with- or 4.without lesions.
Results: We found lower SCV in patients with higher disability level. In early MS (DD 0-5y), SCV (in cm3) was 1.72 in patients with EDSS>3.0 and 1.85 in patients with EDSS≤3.0 (t-test p=0.003). In patients with DD 5-15y, SCV was 1.67 in patients with EDSS>3.0 and 1.77 in patients with EDSS ≤3.0. (p< 0.001). In longstanding MS (DD>15y), SCV was 1.63 in patients with EDSS>3.0 and 1.75 in EDSS≤3.0 (p=0.001). Number of lesions was higher in patients with greater disability levels in all respective group pairs (Mann-Whitney: p =0.01, < 0.001 and 0.005). Presence of diffuse changes was more frequent in patients with higher disability levels. The strongest association between diffuse changes and higher disability level was observed in early MS (DD 0-5y) (45% in EDSS>3 vs. 2.7% in EDSS≤3; χ2-test p< 0.001), followed by patients with DD 5-15y (51 vs. 36.6%; p=0.004), and with DD>15y (57 vs. 43%; p=0.046).
Conclusion: Lower SCV and presence of diffuse SC abnormalities, especially early in the MS course are associated with higher levels of disability.
Disclosure: The project was supported by the Czech Ministry of Education project Progres Q27/LF1, by the Czech Ministry of Health project RVO-VFN64165. Funding for bio statistical support was provided by Novartis
Michaela Andelova received financial support for conference travel from Novartis and Biogen Idec.
Jan Krasensky received research funding from Biogen Idec.
Lukas Sobisek received financial support from Novartis.
Tomas Uher received financial support for conference travel and honoraria from Biogen Idec, Roche, Novartis, Genzyme and Merck Serono.
Barbora Benova received compensation for travelling and conference fees from Novartis and Sanofi Genzyme and Biogen Idec.
Lucie Kadrnozkova received compensation for travelling from Roche.
Karolina Kucerova has nothing to disclose
Zdenek Seidl has received research funding from Biogen.
Eva Havrdova received speaker honoraria and consultant fees from Biogen Idec, Merck Serono, Novartis, Genzyme and Teva, as well as support for research activities from Biogen Idec and Merck Serono.
Dana Horakova received compensation for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck, Bayer, Sanofi Genzyme, and Teva, as well as support for research activities from Biogen Idec. .
Manuela Vaneckova received compensation for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis and Sanofi Genzyme, as well as support for research activities from Biogen Idec.
Abstract: P579
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - 21 Imaging
Objective: To explore significance of spinal cord (SC) pathology in terms of volume, focal lesions and diffuse abnormalities in multiple sclerosis (MS) patients with different levels of disability and disease duration.
Background: SC involvement is common in MS and contributes importantly to disability in progressive disease. The relationship of SC pathology and disability in early and benign MS remains less clear.
Methods: Relapse-remitting and secondary progressive MS patients were selected retrospectively from a large group of over 1000 MS patients examined with SC MRI between January and May 2016. We compared spinal cord volume (SCV) in three groups of patients according to disease duration [0-5; 5-15 and >15 years(y)]. In each group, patients with EDSS >3.0 and ≤3.0 were compared. To eliminate confounding effects of sex, age and disease duration (DD), we matched patients by these parameters. The matching resulted in following group pairs: 1.DD 0-5y (n=76, 26 men); 2.DD 5-15y (n=388, 80 men); 3.DD >15y (n=160, 22 men). SCV was measured as a sum of SC areas from 21 slices centered at intervertebral disk C3/4 on axial 3D-T2w-FatSat sequence acquired at 3T scanner by using an in-house developed semiautomatic method. Types of SC involvement were assessed by neuroradiologist and neurologist, resulting in 4 categories: 1.normally appearing SC, 2.focal lesions, 3.diffuse abnormalities with- or 4.without lesions.
Results: We found lower SCV in patients with higher disability level. In early MS (DD 0-5y), SCV (in cm3) was 1.72 in patients with EDSS>3.0 and 1.85 in patients with EDSS≤3.0 (t-test p=0.003). In patients with DD 5-15y, SCV was 1.67 in patients with EDSS>3.0 and 1.77 in patients with EDSS ≤3.0. (p< 0.001). In longstanding MS (DD>15y), SCV was 1.63 in patients with EDSS>3.0 and 1.75 in EDSS≤3.0 (p=0.001). Number of lesions was higher in patients with greater disability levels in all respective group pairs (Mann-Whitney: p =0.01, < 0.001 and 0.005). Presence of diffuse changes was more frequent in patients with higher disability levels. The strongest association between diffuse changes and higher disability level was observed in early MS (DD 0-5y) (45% in EDSS>3 vs. 2.7% in EDSS≤3; χ2-test p< 0.001), followed by patients with DD 5-15y (51 vs. 36.6%; p=0.004), and with DD>15y (57 vs. 43%; p=0.046).
Conclusion: Lower SCV and presence of diffuse SC abnormalities, especially early in the MS course are associated with higher levels of disability.
Disclosure: The project was supported by the Czech Ministry of Education project Progres Q27/LF1, by the Czech Ministry of Health project RVO-VFN64165. Funding for bio statistical support was provided by Novartis
Michaela Andelova received financial support for conference travel from Novartis and Biogen Idec.
Jan Krasensky received research funding from Biogen Idec.
Lukas Sobisek received financial support from Novartis.
Tomas Uher received financial support for conference travel and honoraria from Biogen Idec, Roche, Novartis, Genzyme and Merck Serono.
Barbora Benova received compensation for travelling and conference fees from Novartis and Sanofi Genzyme and Biogen Idec.
Lucie Kadrnozkova received compensation for travelling from Roche.
Karolina Kucerova has nothing to disclose
Zdenek Seidl has received research funding from Biogen.
Eva Havrdova received speaker honoraria and consultant fees from Biogen Idec, Merck Serono, Novartis, Genzyme and Teva, as well as support for research activities from Biogen Idec and Merck Serono.
Dana Horakova received compensation for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck, Bayer, Sanofi Genzyme, and Teva, as well as support for research activities from Biogen Idec. .
Manuela Vaneckova received compensation for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis and Sanofi Genzyme, as well as support for research activities from Biogen Idec.