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Related Concept Videos

Spinal Cord01:26

Spinal Cord

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The spinal cord, a critical component of the central nervous system, extends from the base of the brainstem to the lumbar region of the vertebral column. It is essential for maintaining physical stability and facilitating communication between the brain and peripheral parts of the body.
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The Spinal Cord01:54

The Spinal Cord

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The spinal cord is the body’s major nerve tract of the central nervous system, communicating afferent sensory information from the periphery to the brain and efferent motor information from the brain to the body. The human spinal cord extends from the hole at the base of the skull, or foramen magnum, to the level of the first or second lumbar vertebra.
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Spinal Cord: Information Processing01:10

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The spinal cord is an integral hub for motor and sensory information that enables the brain to communicate with the peripheral nervous system (PNS). This communication consists of relaying sensory data and transmission of motor commands.
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Spinal Cord: Gross Anatomy01:15

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The spinal cord resides within the protective confines of the vertebral column. It is the main pathway for information traveling between the brain and the body. It plays a fundamental role in nearly all bodily functions, from simple reflexes to complex motor movements. The spinal cord begins at the medulla oblongata at the base of the brainstem and extends downward, terminating at the conus medullaris near the first and second lumbar vertebrae. The spinal cord's length in adults is...
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Spinal Cord: Cross-sectional Anatomy01:16

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The cross-sectional anatomy of the spinal cord offers a detailed view of its complex structure and function within the central nervous system. At the core of the spinal cord lies the gray matter, characterized by its butterfly or "H"-shaped appearance in cross-section. This central region is enveloped by white matter, with the overall structure divided into symmetrical halves by the dorsal median sulcus and the ventral median fissure.
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The different configurations of source-load connections include wye (star) and delta connections. The relationship between line and phase voltages and currents varies depending on the configuration. When the source is supplying power, it is transmitted through the wires to the load, and during this transmission, some power is absorbed by the wires, leading to line loss.
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Preferential spinal cord volume loss in primary progressive multiple sclerosis.

Charidimos Tsagkas1, Stefano Magon1, Laura Gaetano1

  • 1Department of Neurology, University Hospital Basel, University of Basel, Basel, Switzerland / Medical Image Analysis Center (MIAC AG), Basel, Switzerland.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|May 22, 2018
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Summary

Primary progressive multiple sclerosis (PPMS) patients experience faster spinal cord volume (SCV) loss than other MS types. This SCV loss predicts clinical outcomes independently of brain changes.

Keywords:
MRIMultiple sclerosisatrophybiomarkers

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Area of Science:

  • Neurology
  • Neuroimmunology
  • Radiology

Background:

  • Long-term spinal cord volume (SCV) changes in primary progressive multiple sclerosis (PPMS) are not well understood.
  • Spinal cord atrophy is a key feature of multiple sclerosis (MS) pathology.

Purpose of the Study:

  • To longitudinally evaluate spinal cord volume (SCV) loss in primary progressive multiple sclerosis (PPMS).
  • To compare SCV loss in PPMS with relapse-onset multiple sclerosis (MS) subtypes.
  • To correlate SCV loss with clinical outcomes in PPMS.

Main Methods:

  • A 6-year longitudinal study of 60 MS patients (12 PPMS, 24 RRMS, 24 SPMS) matched for age, sex, and disease duration.
  • Annual magnetic resonance imaging (MRI) including 3D T1-weighted MPRAGE for upper cervical SCV, total brain volume (TBV), and brain T2 lesion volume (T2LV).
  • Clinical assessment using the Expanded Disability Status Scale (EDSS).

Main Results:

  • Primary progressive multiple sclerosis (PPMS) patients exhibited significantly faster spinal cord volume (SCV) loss compared to relapsing-remitting MS (RRMS) (p < 0.01) and a trend compared to secondary progressive MS (SPMS) (p = 0.066).
  • In PPMS, SCV loss was independent of total brain volume (TBV) and T2 lesion volume (T2LV) changes, unlike in relapse-onset MS.
  • Spinal cord volume (SCV) was the sole magnetic resonance imaging (MRI) metric associated with increased Expanded Disability Status Scale (EDSS) scores in PPMS (p < 0.01).

Conclusions:

  • Spinal cord volume (SCV) loss is a significant predictor of clinical outcomes in primary progressive multiple sclerosis (PPMS).
  • SCV loss in PPMS is more rapid and occurs independently of brain MRI metrics compared to relapse-onset MS subtypes.
  • Monitoring SCV may be crucial for assessing disease progression and predicting disability in PPMS.