Relevance of early cervical cord volume loss in the disease evolution of clinically isolated syndrome and early multiple sclerosis: a 2-year follow-up study.

Hagström, Inga T; Schneider, Ruth; Bellenberg, Barbara; Salmen, Anke; Weiler, Florian; Köster, Odo; Gold, Ralf; Lukas, Carsten (2017). Relevance of early cervical cord volume loss in the disease evolution of clinically isolated syndrome and early multiple sclerosis: a 2-year follow-up study. Journal of neurology, 264(7), pp. 1402-1412. Springer-Medizin-Verlag 10.1007/s00415-017-8537-5

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Upper cervical cord area (UCCA) atrophy is a prognostic marker for clinical progression in longstanding multiple sclerosis (MS). The objectives of the study were to quantify UCCA atrophy and evaluate its impact in clinically isolated syndrome (CIS) and relapsing-remitting MS (RRMS); to compare converting CIS patients with stable CIS, and to study changes of UCCA and brain white matter (WM) and grey matter (GM) at 2-year follow-up. 110 therapy-naive patients including 53 CIS [6 ± 6 months after symptom onset (SO)] and 57 early RRMS (SO: 12 ± 9 months) underwent sagittal 3D-T1w brain MR (3T). Mean UCCA (C1-C3 level), WM and GM, disability status (EDSS), pyramidal and sensory functional scores, motoric fatigue were assessed at baseline (BL), 12 and 24 months. Volumes were compared with 34 age- and gender-matched healthy controls to assess atrophy. RRMS (78.1 ± 8.7 mm(2), p = 0.011) and converting CIS (77.3 ± 8.0 mm(2), p = 0.046) presented with baseline UCCA atrophy, when compared with controls (82.7 ± 5.2 mm(2)), but not stable CIS (82.6 ± 7.4 mm(2), p = 0.998). Baseline WM was reduced in RRMS (509.3 ± 25.7 ml vs. CONTROLS 528.4 ± 24.1 ml, p = 0.032). Baseline UCCA correlated negative with muscular weakness and fatigability in all patients and RRMS. EDSS exceeding 3 was associated with lower baseline UCCA. Longitudinal atrophy rates were higher in UCCA than in brain volumes. Early cervical cord atrophy in CIS and RRMS was confirmed and may represent a potential new risk marker for conversion from CIS to MS. Baseline atrophy and atrophy change rates were higher in UCCA compared to WM and GM, suggesting that cervical cord volumetry might become an additional MRI marker relevant in future clinical studies in CIS and early MS.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DCR Unit Sahli Building > Forschungsgruppe Neurologie
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Salmen, Anke

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0340-5354

Publisher:

Springer-Medizin-Verlag

Language:

English

Submitter:

Stefanie Hetzenecker

Date Deposited:

23 Oct 2017 08:38

Last Modified:

23 Oct 2017 16:01

Publisher DOI:

10.1007/s00415-017-8537-5

PubMed ID:

28600596

Uncontrolled Keywords:

Brain Cervical cord Clinically isolated syndrome Conversion Multiple sclerosis RRMS

BORIS DOI:

10.7892/boris.102112

URI:

https://boris.unibe.ch/id/eprint/102112

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