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Cervical cord FMRI abnormalities differ between the progressive forms of multiple sclerosis.

Paola Valsasina1, Maria A Rocca, Martina Absinta

  • 1Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, Milan, Italy.

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Patients with progressive multiple sclerosis (MS) exhibit increased cervical cord activity during tactile stimulation. This over-recruitment is more pronounced in secondary progressive MS (SPMS) than primary progressive MS (PPMS), even with similar cord damage.

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Area of Science:

  • Neuroimaging
  • Neuroscience
  • Spinal Cord Research

Background:

  • Multiple Sclerosis (MS) is a progressive neurological disease affecting the central nervous system.
  • Cervical cord functional magnetic resonance imaging (fMRI) can assess sensory processing.
  • Understanding functional changes in the spinal cord is crucial for MS progression.

Purpose of the Study:

  • To compare cervical cord fMRI activity between primary progressive (PPMS) and secondary progressive (SPMS) MS patients during tactile stimulation.
  • To investigate the association between spinal cord recruitment and structural brain and cord damage in MS.

Main Methods:

  • Cervical cord fMRI was performed on 17 healthy controls, 18 SPMS patients, and 16 PPMS patients during right-hand tactile stimulation.
  • fMRI activity and its topographical distribution were analyzed in cord sectors.
  • Correlations between cord recruitment and structural MRI (brain and cord) were assessed.

Main Results:

  • Progressive MS patients showed significantly increased cervical cord recruitment compared to controls.
  • SPMS patients exhibited higher cord activity than PPMS patients, despite similar structural cord damage.
  • Grey matter atrophy in specific cortical and subcortical regions of SPMS patients correlated with cord activity.

Conclusions:

  • Progressive MS is characterized by cervical cord over-recruitment, more evident in SPMS.
  • This functional abnormality may stem from altered spinal cord interneuron modulation due to reduced supratentorial inhibition from brain injury.
  • Findings highlight distinct functional spinal cord changes in different MS progression types.