A Voxel-Based Assessment of Cervical Cord Atrophy in MS Patients (P03.061)

Objective: To apply a voxel-based method to assess the regional distribution of atrophy in the cervical cord of multiple sclerosis (MS) patients with different clinical phenotypes. Background Cervical cord atrophy in MS, measured at a single anatomical level, has been correlated with clinical disability, especially in the progressive forms of the disease. Design/Methods: Brain dual-echo and sagittal 3D T1-weighted cervical cord scans were acquired from 31 healthy controls (HC) and 77 MS patients (15 clinically isolated syndrome [CIS], 15 relapsing remitting [RR] MS, 19 benign MS [BMS], 15 primary progressive MS [PPMS] and 13 secondary progressive [SPMS]). T2 lesion volume (T2LV) was assessed on dual-echo scans. Cervical cord images were analyzed using an active surface (AS) method, which segmented the cord surface from C1 to C7 and created output images reformatted in planes perpendicularly to the estimated cord centre line. Unfolded cervical cord images were co-registered into a common standard space, and smoothed cord binary masks were used as input images for spatial statistics. Between-group comparisons of regional cervical cord atrophy as well as and correlations with clinical and structural MRI variables were assessed (SPM8). Results: Compared to HC, CIS patients showed no cord atrophy, while PPMS had a diffuse cord atrophy. Several clusters of cord atrophy were found in BMS vs. RRMS, SPMS vs. RRMS, BMS and PPMS patients. Atrophy mainly involved the posterior and lateral cord segments at different levels. In PPMS, regional cord atrophy was correlated (p Conclusions: Voxel-based assessment of cervical cord atrophy allows a precise localization of regional cord tissue loss and may contribute to a better characterization of the clinical heterogeneity of MS patients. Disclosure: Dr. Damjanovic has nothing to disclose. Ms. Rocca has received personal compensation for activities with Bayer Schering Pharma and Biogen Idec as a consultant. Dr. Valsasina has nothing to disclose. Dr. Mesaros has received personal compensation for activities with Merck-Serono and Bayer Schering Pharma. Dr. Horsfield has received compensation for serving as a Director of Xinapse Systems Ltd.Dr. Horsfield holds stock and/or stock options in Xinapsse Systems Ltd. Dr. Stosic-Opincal has nothing to disclose. Dr. Drulovic has received personal compensation for activities with Bayer Schering Pharma and Merck Serono S.A. Dr. Comi has received personal compensation for activities with Novartis, Teva Neuroscience, Sanofi-Aventis Pharmaceuticals, Inc., Merck Serono, Bayer Schering, and Biogen Dompe. Dr. Filippi has received personal compensation for activities with ECTRIMS, MSIF, MS Ireland, US NMSS, Bayer-Schering, Biogen-Dompe AG, Genmab, Merck Serono, Pepgen Corporation, Teva, and Sanofi-Aventis. Dr. Filippi has received research support from Teva, Bayer-Schering and Genmab.