Contributions
Abstract: P797
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Introduction: Multiple sclerosis (MS) is characterized by progressive cervical spinal cord (CSC) atrophy. However, the effect of T2 lesion burden of different central nervous system (CNS) compartments on CSC atrophy has not been investigated yet. Here, we assessed the influence of brain, CSC and thoracic spinal cord (TSC) T2-hyperintense lesions on CSC atrophy. Relationships with patients' disability were also investigated.
Methods: Thirty-four MS patients (28 relapsing-remitting and 6 progressive MS) underwent brain, cervical and thoracic spinal cord MRI at 3T, and expanded disability status scale (EDSS) score assessment.
Sagittal T2-weighted and proton density scans, and axial multi echo (MEDIC) images were used to assess T2-hyperintense lesion volume (T2 LV) and count (T2 LC) of the cervical and thoracic spinal cord segments. Brain T2 LV was obtained from axial dual echo images. 3D T1-weighted scans were employed to assess the normalized whole CSC cross-sectional area (CSAn) using an active surface method. Age- and sex-adjusted multiple regression models were used to assess univariate correlations of brain and cord T2 LVs/LCs with CSAn and EDSS. The same modelling was used to identify the set of variables independently associated with CSAn and EDSS using a stepwise variable selection.
Results: At the univariate analysis, CSAn was significantly associated with CSC T2 LV (β=-036, p=0.03), but not with TSC (p=0.5) or brain (p=0.2) T2 LV. The same analysis showed a significant association between EDSS and CSC T2 LV (β=0.42, p=0.01) and brain T2 LV (β=0.34, p=0.04), and a trend towards an association with TSC LC (β=0.30, p=0.07), while the EDSS score and CSAn were not significantly correlated (p=0.29).
The multivariable regression analyses retained age, sex and CSC T2 LV as significant predictors of CSAn (explained variance=20%, p=0.023) and EDSS score (explained variance=31%, p=0.004).
Conclusion: CSC T2 LV had a significant influence on CSAn, suggesting an effect of secondary degenerative processes on CSC atrophy development. The overall CNS T2 lesion burden was more tightly correlated than CSC atrophy to the disability status of our patients.
Disclosure: E. Pravatà: nothing to disclose
P. Valsasina: nothing to disclose
M.A. Rocca received speakers honoraria from Biogen Idec, Novartis, Genzyme, Sanofi-Aventis, Teva, Merck Serono, and Roche and receives research support from the Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla.
Prof. Filippi is Editor-in-Chief of the Journal of Neurology; received compensation for consulting services and/or speaking activities from Biogen Idec, Merck-Serono, Novartis, Teva Pharmaceutical Industries; and receives research support from Biogen Idec, Merck-Serono, Novartis, Teva Pharmaceutical Industries, Roche, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla, and ARiSLA (Fondazione Italiana di Ricerca per la SLA).
C. Zecca, C. Gobbi: The Department of Neurology, Regional Hospital Lugano (EOC), Lugano, Switzerland receives financial support from Teva, Merck Serono, Biogen, Genzyme, Roche, Celgene, Bayer and Novartis.
Abstract: P797
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Introduction: Multiple sclerosis (MS) is characterized by progressive cervical spinal cord (CSC) atrophy. However, the effect of T2 lesion burden of different central nervous system (CNS) compartments on CSC atrophy has not been investigated yet. Here, we assessed the influence of brain, CSC and thoracic spinal cord (TSC) T2-hyperintense lesions on CSC atrophy. Relationships with patients' disability were also investigated.
Methods: Thirty-four MS patients (28 relapsing-remitting and 6 progressive MS) underwent brain, cervical and thoracic spinal cord MRI at 3T, and expanded disability status scale (EDSS) score assessment.
Sagittal T2-weighted and proton density scans, and axial multi echo (MEDIC) images were used to assess T2-hyperintense lesion volume (T2 LV) and count (T2 LC) of the cervical and thoracic spinal cord segments. Brain T2 LV was obtained from axial dual echo images. 3D T1-weighted scans were employed to assess the normalized whole CSC cross-sectional area (CSAn) using an active surface method. Age- and sex-adjusted multiple regression models were used to assess univariate correlations of brain and cord T2 LVs/LCs with CSAn and EDSS. The same modelling was used to identify the set of variables independently associated with CSAn and EDSS using a stepwise variable selection.
Results: At the univariate analysis, CSAn was significantly associated with CSC T2 LV (β=-036, p=0.03), but not with TSC (p=0.5) or brain (p=0.2) T2 LV. The same analysis showed a significant association between EDSS and CSC T2 LV (β=0.42, p=0.01) and brain T2 LV (β=0.34, p=0.04), and a trend towards an association with TSC LC (β=0.30, p=0.07), while the EDSS score and CSAn were not significantly correlated (p=0.29).
The multivariable regression analyses retained age, sex and CSC T2 LV as significant predictors of CSAn (explained variance=20%, p=0.023) and EDSS score (explained variance=31%, p=0.004).
Conclusion: CSC T2 LV had a significant influence on CSAn, suggesting an effect of secondary degenerative processes on CSC atrophy development. The overall CNS T2 lesion burden was more tightly correlated than CSC atrophy to the disability status of our patients.
Disclosure: E. Pravatà: nothing to disclose
P. Valsasina: nothing to disclose
M.A. Rocca received speakers honoraria from Biogen Idec, Novartis, Genzyme, Sanofi-Aventis, Teva, Merck Serono, and Roche and receives research support from the Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla.
Prof. Filippi is Editor-in-Chief of the Journal of Neurology; received compensation for consulting services and/or speaking activities from Biogen Idec, Merck-Serono, Novartis, Teva Pharmaceutical Industries; and receives research support from Biogen Idec, Merck-Serono, Novartis, Teva Pharmaceutical Industries, Roche, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla, and ARiSLA (Fondazione Italiana di Ricerca per la SLA).
C. Zecca, C. Gobbi: The Department of Neurology, Regional Hospital Lugano (EOC), Lugano, Switzerland receives financial support from Teva, Merck Serono, Biogen, Genzyme, Roche, Celgene, Bayer and Novartis.