Contributions
Abstract: 217
Type: Oral
Abstract Category: Pathology and pathogenesis of MS - 21 Imaging
Background: Spinal cord(SC) pathology is common in multiple sclerosis(MS). Prior studies have shown that quantitative SC-MRI measures correlate with MS-related clinical disability. To date, the evaluation of longitudinal changes in quantitative SC-MRI in MS has been limited.
Objectives: To assess quantitative SC-MRI measures over a median follow-up period of 5.7 years, and to characterize the relationship between changes in quantitative SC-MRI with clinical disability.
Methods: 75 MS patients underwent annual longitudinal 3T SC-MRI and clinical assessment including expanded disability status scale(EDSS). Regions-of-interest circumscribing axial SC cross-sectional area (CSA) at C3-C4 were used to obtain: CSA, fractional anisotropy(FA), mean, perpendicular, parallel diffusivity(MD, λ⊥, λ||,) and magnetization-transfer ratio(MTR). Mixed-effects regression incorporating subject-specific intercepts and slopes was utilized to assess longitudinal change in individual SC-MRI measures. Pearson's correlation coefficient(r) assessed relationships between subject-specific slopes and follow-up EDSS scores.
Results: MTR decreased (p=0.04) and MD increased (p=0.07) over the median follow-up period of 5.7 years. There were moderately strong correlations between baseline SC MRI measures and follow-up EDSS scores (r with FA=-0.35(p< 0.01); MD=0.23(p=0.05); λ⊥=0.37(p< 0.01); MTR=-0.30(p=0.01); SC-CSA=-0.43(p< 0.01), and subject-specific slopes of individual SC-MRI indices and follow-up EDSS scores at both 2 and 5 years [2 years: r with FA=-0.29 (p< 0.001); MD=0.33 (p< 0.001); λ⊥=0.36
(p< 0.001); λ||=0.17(p=0.01), MTR=-0.28(p< 0.001); SC-CSA=-0.34(p< 0.001); at 5 years: r with FA=-0.33(p< 0.001); λ⊥=0.39(p< 0.001); λ||=-0.11(p=0.05), MTR=-0.36 (p< 0.001); SC-CSA=-0.36
(p< 0.001)]. Individuals with rates of change in FA, λ⊥, λ||, MTR and SC-CSA higher than that of the study sample mean showed substantially stronger correlations with follow-up clinical measures.
Conclusions: In MS, changes in some quantitative SC-MRI indices are measurable over 5 years, likely reflecting ongoing pathological processes. Of clinical relevance is that baseline and subject-specific trajectories of SC-MRI index changes at both 2 and 5 years are highly relevant to disability at follow-up. This suggests that baseline SC MRI measures and individual dynamics of change must be taken into account when interpreting longitudinal SC-MRI measures and expanding the clinical utility of these techniques.
Disclosure:
Dr. Jiwon Oh has received grant funding from the MS Society of Canada, National MS Society. She has received research funding support from Biogen-Idec and Sanofi-Genzyme. She has also received personal compensation for consulting or speaking from EMD-Serono, Genzyme, Biogen-Idec, Novartis, Teva, and Roche.
Kateryna Cybulsky has nothing to disclose.
Dr. Min Chen has nothing to disclose.
Dr. Aaron Carass has nothing to disclose.
Dr. Marie Diener-West has nothing to dislose.
Dr. Peter van Zijl is a paid lecturer for Philips Medical Systems.This arrangement has been approved by Johns Hopkins University in accordance with its conflict of interest policies.
Dr. Jerry Prince has nothing to disclose.
Dr. Daniel Reich receives research support from Vertex Pharmaceuticals.
Dr. Peter Calabresi has received personal consulting fees from Biogen
and is principal investigator on grants to Johns Hopkins University from MedImmune, Annexon, Teva, Novartis, Genzyme and Biogen.
Abstract: 217
Type: Oral
Abstract Category: Pathology and pathogenesis of MS - 21 Imaging
Background: Spinal cord(SC) pathology is common in multiple sclerosis(MS). Prior studies have shown that quantitative SC-MRI measures correlate with MS-related clinical disability. To date, the evaluation of longitudinal changes in quantitative SC-MRI in MS has been limited.
Objectives: To assess quantitative SC-MRI measures over a median follow-up period of 5.7 years, and to characterize the relationship between changes in quantitative SC-MRI with clinical disability.
Methods: 75 MS patients underwent annual longitudinal 3T SC-MRI and clinical assessment including expanded disability status scale(EDSS). Regions-of-interest circumscribing axial SC cross-sectional area (CSA) at C3-C4 were used to obtain: CSA, fractional anisotropy(FA), mean, perpendicular, parallel diffusivity(MD, λ⊥, λ||,) and magnetization-transfer ratio(MTR). Mixed-effects regression incorporating subject-specific intercepts and slopes was utilized to assess longitudinal change in individual SC-MRI measures. Pearson's correlation coefficient(r) assessed relationships between subject-specific slopes and follow-up EDSS scores.
Results: MTR decreased (p=0.04) and MD increased (p=0.07) over the median follow-up period of 5.7 years. There were moderately strong correlations between baseline SC MRI measures and follow-up EDSS scores (r with FA=-0.35(p< 0.01); MD=0.23(p=0.05); λ⊥=0.37(p< 0.01); MTR=-0.30(p=0.01); SC-CSA=-0.43(p< 0.01), and subject-specific slopes of individual SC-MRI indices and follow-up EDSS scores at both 2 and 5 years [2 years: r with FA=-0.29 (p< 0.001); MD=0.33 (p< 0.001); λ⊥=0.36
(p< 0.001); λ||=0.17(p=0.01), MTR=-0.28(p< 0.001); SC-CSA=-0.34(p< 0.001); at 5 years: r with FA=-0.33(p< 0.001); λ⊥=0.39(p< 0.001); λ||=-0.11(p=0.05), MTR=-0.36 (p< 0.001); SC-CSA=-0.36
(p< 0.001)]. Individuals with rates of change in FA, λ⊥, λ||, MTR and SC-CSA higher than that of the study sample mean showed substantially stronger correlations with follow-up clinical measures.
Conclusions: In MS, changes in some quantitative SC-MRI indices are measurable over 5 years, likely reflecting ongoing pathological processes. Of clinical relevance is that baseline and subject-specific trajectories of SC-MRI index changes at both 2 and 5 years are highly relevant to disability at follow-up. This suggests that baseline SC MRI measures and individual dynamics of change must be taken into account when interpreting longitudinal SC-MRI measures and expanding the clinical utility of these techniques.
Disclosure:
Dr. Jiwon Oh has received grant funding from the MS Society of Canada, National MS Society. She has received research funding support from Biogen-Idec and Sanofi-Genzyme. She has also received personal compensation for consulting or speaking from EMD-Serono, Genzyme, Biogen-Idec, Novartis, Teva, and Roche.
Kateryna Cybulsky has nothing to disclose.
Dr. Min Chen has nothing to disclose.
Dr. Aaron Carass has nothing to disclose.
Dr. Marie Diener-West has nothing to dislose.
Dr. Peter van Zijl is a paid lecturer for Philips Medical Systems.This arrangement has been approved by Johns Hopkins University in accordance with its conflict of interest policies.
Dr. Jerry Prince has nothing to disclose.
Dr. Daniel Reich receives research support from Vertex Pharmaceuticals.
Dr. Peter Calabresi has received personal consulting fees from Biogen
and is principal investigator on grants to Johns Hopkins University from MedImmune, Annexon, Teva, Novartis, Genzyme and Biogen.