TY - JOUR
T1 - Five-year longitudinal changes in quantitative spinal cord MRI in multiple sclerosis
AU - Oh, Jiwon
AU - Chen, Min
AU - Cybulsky, Kateryna
AU - Suthiphosuwan, Suradech
AU - Seyman, Estelle
AU - Dewey, Blake
AU - Diener-West, Marie
AU - van Zijl, Peter
AU - Prince, Jerry
AU - Reich, Daniel S.
AU - Calabresi, Peter A.
N1 - Publisher Copyright:
© The Author(s), 2020.
PY - 2021/4
Y1 - 2021/4
N2 - Background: The spinal cord (SC) is highly relevant to disability in multiple sclerosis (MS), but few studies have evaluated longitudinal changes in quantitative spinal cord magnetic resonance imaging (SC-MRI). Objectives: The aim of this study was to characterize the relationships between 5-year changes in SC-MRI with disability in MS. Methods: In total, 75 MS patients underwent 3 T SC-MRI and clinical assessment (expanded disability status scale (EDSS) and MS functional composite (MSFC)) at baseline, 2 and 5 years. SC-cross-sectional area (CSA) and diffusion-tensor indices (fractional anisotropy (FA), mean, perpendicular, parallel diffusivity (MD, λ⊥, λ||) and magnetization transfer ratio (MTR)) were extracted at C3–C4. Mixed-effects regression incorporating subject-specific slopes assessed longitudinal change in SC-MRI measures. Results: SC-CSA and MTR decreased (p = 0.009, p = 0.03) over 5.1 years. There were moderate correlations between 2- and 5-year subject-specific slopes of SC-MRI indices and follow-up EDSS scores (Pearson’s r with FA = −0.23 (p < 0.001); MD = 0.31 (p < 0.001); λ⊥ = 0.34 (p < 0.001); λ|| = −0.12 (p = 0.05), MTR = −0.37 (p < 0.001); SC-CSA = −0.47 (p < 0.001) at 5 years); MSFC showed similar trends. The 2- and 5-year subject-specific slopes were robustly correlated (r = 0.93–0.97 for FA, λ⊥, SC-CSA and MTR, all ps < 0.001). Conclusion: In MS, certain quantitative SC-MRI indices change over 5 years, reflecting ongoing tissue changes. Subject-specific trajectories of SC-MRI index change at 2 and 5 years are strongly correlated and highly relevant to follow-up disability. These findings suggest that individual dynamics of change should be accounted for when interpreting longitudinal SC-MRI measures and that measuring short-term change is predictive of long-term clinical disability.
AB - Background: The spinal cord (SC) is highly relevant to disability in multiple sclerosis (MS), but few studies have evaluated longitudinal changes in quantitative spinal cord magnetic resonance imaging (SC-MRI). Objectives: The aim of this study was to characterize the relationships between 5-year changes in SC-MRI with disability in MS. Methods: In total, 75 MS patients underwent 3 T SC-MRI and clinical assessment (expanded disability status scale (EDSS) and MS functional composite (MSFC)) at baseline, 2 and 5 years. SC-cross-sectional area (CSA) and diffusion-tensor indices (fractional anisotropy (FA), mean, perpendicular, parallel diffusivity (MD, λ⊥, λ||) and magnetization transfer ratio (MTR)) were extracted at C3–C4. Mixed-effects regression incorporating subject-specific slopes assessed longitudinal change in SC-MRI measures. Results: SC-CSA and MTR decreased (p = 0.009, p = 0.03) over 5.1 years. There were moderate correlations between 2- and 5-year subject-specific slopes of SC-MRI indices and follow-up EDSS scores (Pearson’s r with FA = −0.23 (p < 0.001); MD = 0.31 (p < 0.001); λ⊥ = 0.34 (p < 0.001); λ|| = −0.12 (p = 0.05), MTR = −0.37 (p < 0.001); SC-CSA = −0.47 (p < 0.001) at 5 years); MSFC showed similar trends. The 2- and 5-year subject-specific slopes were robustly correlated (r = 0.93–0.97 for FA, λ⊥, SC-CSA and MTR, all ps < 0.001). Conclusion: In MS, certain quantitative SC-MRI indices change over 5 years, reflecting ongoing tissue changes. Subject-specific trajectories of SC-MRI index change at 2 and 5 years are strongly correlated and highly relevant to follow-up disability. These findings suggest that individual dynamics of change should be accounted for when interpreting longitudinal SC-MRI measures and that measuring short-term change is predictive of long-term clinical disability.
KW - Multiple sclerosis
KW - diffusion-tensor imaging
KW - magnetization-transfer imaging
KW - quantitative MRI
KW - spinal cord
UR - http://www.scopus.com/inward/record.url?scp=85085701874&partnerID=8YFLogxK
U2 - 10.1177/1352458520923970
DO - 10.1177/1352458520923970
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C2 - 32476593
AN - SCOPUS:85085701874
SN - 1352-4585
VL - 27
SP - 549
EP - 558
JO - Multiple Sclerosis Journal
JF - Multiple Sclerosis Journal
IS - 4
ER -