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Spinal cord atrophy and disability in MS: a longitudinal study
V L Stevenson1, S M Leary, N A Losseff
1NMR Research Unit, Institute of Neurology, Queens Square, London, UK.
Neurology
|July 23, 1998
Summary
Spinal cord atrophy can be reliably measured in patients with multiple sclerosis (MS). This serial measurement of cord cross-sectional area shows significant loss over time, particularly in progressive MS, aiding therapeutic evaluation.
Area of Science:
- Neurology
- Neuroimaging
- Multiple Sclerosis Research
Background:
- Spinal cord involvement is common in multiple sclerosis (MS) and contributes to disability.
- While lesion load shows little correlation with disability, spinal cord atrophy strongly correlates with the Expanded Disability Status Scale (EDSS) in cross-sectional studies.
Purpose of the Study:
- To reliably measure changes in spinal cord cross-sectional area over a 1-year period in MS patients.
- To assess the feasibility of serial spinal cord atrophy measurements for evaluating treatment efficacy.
Main Methods:
- A reproducible semiautomated technique was used to measure the cross-sectional area of the spinal cord at the C2 level.
- Measurements were taken serially over 12 months in 28 MS patients and 13 healthy control subjects.
Main Results:
- MS patients exhibited significantly smaller baseline cord cross-sectional areas compared to controls (71.25 mm² vs. 80.95 mm²).
- Patients showed a significant reduction in cord cross-sectional area over 12 months (p < 0.001), unlike controls.
- Primary progressive MS patients had the most marked atrophy (5.2% loss), while secondary progressive and benign MS showed minimal changes.
Conclusions:
- This study demonstrates the feasibility of reliably measuring spinal cord cross-sectional area changes over time.
- Serial measurement of spinal cord atrophy is a valuable tool for assessing therapeutic efficacy in MS, especially in primary progressive forms.