Contributions
Abstract: P1148
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Introduction: In order to assess differences in the relationships between cord grey and white matter areas and methods practiced to quantify loss of sensorimotor function in patients suffering with Multiple Sclerosis (MS), a cohort of patients and healthy controls received MR imaging and sensorimotor function assessed from three perspectives: (1) physician evaluations using traditional methods; (2) questionnaires on patient interpreted disability; (3) exams using sensorimotor instruments.
Methods: 50 MS patients (23 men, 27 women) plus 10 healthy controls, ages 18-70 underwent MRI scans including an axial scan of the C2-C3 cervical spine. The spinal cord image was segmented using Jim 7.0 to calculate a total cord area (TCA) and grey matter area (GMA). The physician evaluation metrics included EDSS (Expanded Disability Status Scale), 25-ft walk time (WT) and 9-hole peg test (9HPT). Questionnaires consisted of PREDSS (Patient Reported EDSS), AI (Ambulatory Index), Disability Scale (DS), Neurological Rating Scale (NRS), Functional Scale (FS), Walking Assistance (WA), and WHODAS (World Health Org. Disability Assessment). Instrumental exams employed the microFET hand held neck and arm strength dynamometer, sensory assessment with Vibatron multi-frequency generator, and Jamar digital grip strength dynamometer. Least squares regression models were evaluated with cord areas and sex as independent variables to predict functional metrics.
Results: GMA and TCA were correlated with traditional clinical MS metrics of EDSS (p= 0.0073, p=0.014), 25-foot walk (p=0.028, p=0.014) and the 9HPT (p=0.0056, p=0.0083); sex was not a significant covariant.
All sensorimotor patient reported metrics correlated with GMA (AI p=0.0031, PREDSS p=0.0009, FS p=0.032, NRS p=0.020, DS p=0.032, WA p=0.0061) and/or TCA (AI p=0.0014, PREDSS p=0.0006, FS p=0.070, NRS p=0.029, DS p=0.052, WA p=0.0087). WHODAS was not significantly correlated with any MR cord metrics.
Sensorimotor instrumental metrics showed MRI correlations for sensation (GMA p=0.0011, sex p=0.0041), arm (TCA p=0.0052, sex p=0.0009), neck (TCA p=0.025, sex p< 0.0001), and grip strength (TCA p=0.03, sex p< 0.0001).
Conclusion: All sensorimotor metrics correlated with spinal cord grey matter or whole cord areas suggesting utility of patient reported sensorimotor metrics. Unlike physician and patient reported metrics, instrumental metrics measuring force had to be adjusted for sex due to normal differences of strength between men and women.
Disclosure: Funding for Study: US Department of Defense A.M. Alexander: nothing to disclose. J.K. Arjona: nothing to disclose. J. Graves: nothing to disclose. V. Block: nothing to disclose. N. Papinutto: nothing to disclose. W.A. Stern: nothing to disclose. J.M. Gelfand: nothing to disclose. A. Bischof: nothing to disclose. A.R. Romeo: nothing to disclose. S. Jia: nothing to disclose. B.A.C. Cree: nothing to disclose. S.L. Hauser: nothing to disclose. R.G. Henry: nothing to disclose.
Abstract: P1148
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Introduction: In order to assess differences in the relationships between cord grey and white matter areas and methods practiced to quantify loss of sensorimotor function in patients suffering with Multiple Sclerosis (MS), a cohort of patients and healthy controls received MR imaging and sensorimotor function assessed from three perspectives: (1) physician evaluations using traditional methods; (2) questionnaires on patient interpreted disability; (3) exams using sensorimotor instruments.
Methods: 50 MS patients (23 men, 27 women) plus 10 healthy controls, ages 18-70 underwent MRI scans including an axial scan of the C2-C3 cervical spine. The spinal cord image was segmented using Jim 7.0 to calculate a total cord area (TCA) and grey matter area (GMA). The physician evaluation metrics included EDSS (Expanded Disability Status Scale), 25-ft walk time (WT) and 9-hole peg test (9HPT). Questionnaires consisted of PREDSS (Patient Reported EDSS), AI (Ambulatory Index), Disability Scale (DS), Neurological Rating Scale (NRS), Functional Scale (FS), Walking Assistance (WA), and WHODAS (World Health Org. Disability Assessment). Instrumental exams employed the microFET hand held neck and arm strength dynamometer, sensory assessment with Vibatron multi-frequency generator, and Jamar digital grip strength dynamometer. Least squares regression models were evaluated with cord areas and sex as independent variables to predict functional metrics.
Results: GMA and TCA were correlated with traditional clinical MS metrics of EDSS (p= 0.0073, p=0.014), 25-foot walk (p=0.028, p=0.014) and the 9HPT (p=0.0056, p=0.0083); sex was not a significant covariant.
All sensorimotor patient reported metrics correlated with GMA (AI p=0.0031, PREDSS p=0.0009, FS p=0.032, NRS p=0.020, DS p=0.032, WA p=0.0061) and/or TCA (AI p=0.0014, PREDSS p=0.0006, FS p=0.070, NRS p=0.029, DS p=0.052, WA p=0.0087). WHODAS was not significantly correlated with any MR cord metrics.
Sensorimotor instrumental metrics showed MRI correlations for sensation (GMA p=0.0011, sex p=0.0041), arm (TCA p=0.0052, sex p=0.0009), neck (TCA p=0.025, sex p< 0.0001), and grip strength (TCA p=0.03, sex p< 0.0001).
Conclusion: All sensorimotor metrics correlated with spinal cord grey matter or whole cord areas suggesting utility of patient reported sensorimotor metrics. Unlike physician and patient reported metrics, instrumental metrics measuring force had to be adjusted for sex due to normal differences of strength between men and women.
Disclosure: Funding for Study: US Department of Defense A.M. Alexander: nothing to disclose. J.K. Arjona: nothing to disclose. J. Graves: nothing to disclose. V. Block: nothing to disclose. N. Papinutto: nothing to disclose. W.A. Stern: nothing to disclose. J.M. Gelfand: nothing to disclose. A. Bischof: nothing to disclose. A.R. Romeo: nothing to disclose. S. Jia: nothing to disclose. B.A.C. Cree: nothing to disclose. S.L. Hauser: nothing to disclose. R.G. Henry: nothing to disclose.