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Cervical cord area is associated with infratentorial grey and white matter volume predominantly in relapsing-remitting multiple sclerosis: A study using semi-automated cord volumetry and voxel-based morphometry.
Mult Scler Relat Disord 2015; 4(3):264-72MS

Abstract

BACKGROUND AND PURPOSE

Atrophy of the brain and the upper cervical cord, which both have major impact on the severity of clinical symptoms in multiple sclerosis (MS), may be interrelated by neuraxonal degeneration. Aiming to identify possible spatially remote effects of neuraxonal brain damage on spinal cord atrophy, we studied regional and global brain volumes and the upper cervical cord area (UCCA) in a large group of MS patients and a healthy control group.

METHODS

In a group of 132 MS patients (71 relapsing-remitting MS; 61 secondary progressive MS; median [range] of EDSS: 5 [0-7], respectively 6 [2-8.5] and mean±standard deviation of age/disease duration: 37±11 years/6.7±6.3 years; respectively: 49±8 years/14.5±8.0 years) and 45 healthy subjects UCCA, regional and global brain volumes, and brain lesion load were assessed. Associations between MRI results and clinical parameters in the entire cohort and differentiated according to MS-subtype were investigated using t-tests, partial correlation analyses, voxel-based morphometry and statistical parametric mapping.

RESULTS

Exclusively in RRMS, a significant positive correlation of UCCA with cerebellar cortical grey matter (GM) in the vermis and with regional white matter volume in the entire brainstem, corresponding to the corticospinal tracts, was detected. Although SPMS patients were considerably more affected by disability and decrease of UCCA (RRMS:75.2±10.4 mm(2); SPMS: 66.0±11.8 mm(2),controls: 84.5±8.7mm(2)), brain grey matter (RRMS:585.8±53.6 ml; SPMS: 528.2±61.5 ml, controls: 608.7±48.1 ml) and total brain volume (RRMS:1162.9±41.8 ml; SPMS: 1117.9±51.2 ml, controls: 1194.1±19.5 ml) than RRMS patients, significant positive associations in this group were found only between UCCA and a cluster of white matter in the medulla, but not in grey matter.

CONCLUSION

Cervical cord and brain atrophy were present in both, RRMS and even more severe in SPMS. Still, spatial associations between cervical cord area and remote cerebellar and brainstem volume, possibly driven by neuraxonal degeneration, were detected mostly in RRMS patients with predominantly short disease durations. Future longitudinal studies may elucidate the interplay between affection of spinal cord and infratentorial structures in MS, and contribute to the understanding of the conversion processes from relapsing-remitting to secondary progressive MS.

Authors+Show Affiliations

Department of Radiology, St. Josef-Hospital, Ruhr-University Bochum, Germany. Electronic address: b.bellenberg@klinikum-bochum.de.Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Germany.Fraunhofer-MEVIS, Institute for Medical Image Computing, Bremen, Germany.Institute of Cognitive Neuroscience, Department of Neuropsychology, Ruhr-University Bochum, Germany.Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Germany.Department of Human Genetics, Ruhr-University Bochum, Germany.Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Germany.Department of Radiology, St. Josef-Hospital, Ruhr-University Bochum, Germany.Department of Radiology, St. Josef-Hospital, Ruhr-University Bochum, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26008944

Citation

Bellenberg, B, et al. "Cervical Cord Area Is Associated With Infratentorial Grey and White Matter Volume Predominantly in Relapsing-remitting Multiple Sclerosis: a Study Using Semi-automated Cord Volumetry and Voxel-based Morphometry." Multiple Sclerosis and Related Disorders, vol. 4, no. 3, 2015, pp. 264-72.
Bellenberg B, Schneider R, Weiler F, et al. Cervical cord area is associated with infratentorial grey and white matter volume predominantly in relapsing-remitting multiple sclerosis: A study using semi-automated cord volumetry and voxel-based morphometry. Mult Scler Relat Disord. 2015;4(3):264-72.
Bellenberg, B., Schneider, R., Weiler, F., Suchan, B., Haghikia, A., Hoffjan, S., ... Lukas, C. (2015). Cervical cord area is associated with infratentorial grey and white matter volume predominantly in relapsing-remitting multiple sclerosis: A study using semi-automated cord volumetry and voxel-based morphometry. Multiple Sclerosis and Related Disorders, 4(3), pp. 264-72. doi:10.1016/j.msard.2015.04.003.
Bellenberg B, et al. Cervical Cord Area Is Associated With Infratentorial Grey and White Matter Volume Predominantly in Relapsing-remitting Multiple Sclerosis: a Study Using Semi-automated Cord Volumetry and Voxel-based Morphometry. Mult Scler Relat Disord. 2015;4(3):264-72. PubMed PMID: 26008944.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cervical cord area is associated with infratentorial grey and white matter volume predominantly in relapsing-remitting multiple sclerosis: A study using semi-automated cord volumetry and voxel-based morphometry. AU - Bellenberg,B, AU - Schneider,R, AU - Weiler,F, AU - Suchan,B, AU - Haghikia,A, AU - Hoffjan,S, AU - Gold,R, AU - Köster,O, AU - Lukas,C, Y1 - 2015/04/15/ PY - 2014/07/04/received PY - 2015/03/21/revised PY - 2015/04/04/accepted PY - 2015/5/27/entrez PY - 2015/5/27/pubmed PY - 2016/2/18/medline KW - Brain grey matter KW - Brain white matter KW - MRI KW - Multiple sclerosis KW - Upper cervical cord area KW - Voxel based morphometry SP - 264 EP - 72 JF - Multiple sclerosis and related disorders JO - Mult Scler Relat Disord VL - 4 IS - 3 N2 - BACKGROUND AND PURPOSE: Atrophy of the brain and the upper cervical cord, which both have major impact on the severity of clinical symptoms in multiple sclerosis (MS), may be interrelated by neuraxonal degeneration. Aiming to identify possible spatially remote effects of neuraxonal brain damage on spinal cord atrophy, we studied regional and global brain volumes and the upper cervical cord area (UCCA) in a large group of MS patients and a healthy control group. METHODS: In a group of 132 MS patients (71 relapsing-remitting MS; 61 secondary progressive MS; median [range] of EDSS: 5 [0-7], respectively 6 [2-8.5] and mean±standard deviation of age/disease duration: 37±11 years/6.7±6.3 years; respectively: 49±8 years/14.5±8.0 years) and 45 healthy subjects UCCA, regional and global brain volumes, and brain lesion load were assessed. Associations between MRI results and clinical parameters in the entire cohort and differentiated according to MS-subtype were investigated using t-tests, partial correlation analyses, voxel-based morphometry and statistical parametric mapping. RESULTS: Exclusively in RRMS, a significant positive correlation of UCCA with cerebellar cortical grey matter (GM) in the vermis and with regional white matter volume in the entire brainstem, corresponding to the corticospinal tracts, was detected. Although SPMS patients were considerably more affected by disability and decrease of UCCA (RRMS:75.2±10.4 mm(2); SPMS: 66.0±11.8 mm(2),controls: 84.5±8.7mm(2)), brain grey matter (RRMS:585.8±53.6 ml; SPMS: 528.2±61.5 ml, controls: 608.7±48.1 ml) and total brain volume (RRMS:1162.9±41.8 ml; SPMS: 1117.9±51.2 ml, controls: 1194.1±19.5 ml) than RRMS patients, significant positive associations in this group were found only between UCCA and a cluster of white matter in the medulla, but not in grey matter. CONCLUSION: Cervical cord and brain atrophy were present in both, RRMS and even more severe in SPMS. Still, spatial associations between cervical cord area and remote cerebellar and brainstem volume, possibly driven by neuraxonal degeneration, were detected mostly in RRMS patients with predominantly short disease durations. Future longitudinal studies may elucidate the interplay between affection of spinal cord and infratentorial structures in MS, and contribute to the understanding of the conversion processes from relapsing-remitting to secondary progressive MS. SN - 2211-0356 UR - https://www.unboundmedicine.com/medline/citation/26008944/Cervical_cord_area_is_associated_with_infratentorial_grey_and_white_matter_volume_predominantly_in_relapsing_remitting_multiple_sclerosis:_A_study_using_semi_automated_cord_volumetry_and_voxel_based_morphometry_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2211-0348(15)00042-5 DB - PRIME DP - Unbound Medicine ER -