In vivo imaging of spinal cord atrophy in neuroinflammatory diseases

Abstract

Objective Spinal cord atrophy is prominent in chronic progressive neurologic diseases such as Human-T-cell lymphotropic virus type-1 (HTLV-1) associated myelopathy/tropical spastic paraparesis (HAM/TSP) and multiple sclerosis (MS). Here we compared the spinal cord cross-sectional area (SCCSA) in HAM/TSP and MS to that of healthy volunteers (HV). Methods SCCSA and clinical disability scores were measured in 18 HAM/TSP, 4 asymptomatic carriers (AC) of HTLV-1, 18 MS, and 10 HV from a 3T MRI. SCCSA measured in patients and AC were compared to that of HV and correlated with disability scores. Results The entire spinal cord in HAM/TSP was thin compared to HV, whereas only the cervical cord in MS was thinner than HV (p<0·0001). In HAM/TSP, SCCSA extensively correlated with Ambulation Index, whereas only the cervical cord correlated with disease duration (p<0·05). In MS, the SCCSA extensively correlated with Scripps Neurologic Rating Score and the Expanded Disability Status Scale (p<0·05). One of the four ACs showed atrophy in a pattern similar to HAM/TSP. Interpretation These results are in accordance with the findings that whereas over half of all lesions in an MS cord are seen in the upper cervical cord, most of the pathology in HAM/TSP is seen in the thoracolumbar cord, which in turn may be responsible for more extensive cord atrophy seen in HAM/TSP. Imaging marker such as SCCSA might serve as a surrogate endpoint in clinical trials, especially to assess the neuroprotective impact of various therapies.

HTLV-1 Infection and Neuropathogenesis in the Context of Rag1-/-γc-/- (RAG1-Hu) and BLT Mice

“…Based on the demyelination scores, there is no significant change in the amount of myelin degeneration between the two mouse models, albeit the Rag1 mice show marginally higher scores. This correlates with other studies that have shown axonal loss and demyelination as clinical manifestations of HAM/TSP seen on histopathology (Liu et al 2014). In this study the data from the hu-mice has also corroborated previous findings that have reported stable PVL despite disease progression due to neurodegeneration (Liu et al 2014; Olavarria et al 2012).…”

Structural characteristics of the central nervous system in Friedreich ataxia: an in vivo spinal cord and brain MRI study

“…T1-weighted spinal cord MRI was acquired on a 3T Prisma scanner (Siemens) using a three-dimensional (3D) gradient-echo sequence (TR=7.8 ms, TE=3 ms, flip angle=16°, 1 mm resolution, field of view: 256 mm (cervical), 320 mm (thoracic)) 3. Brain imaging was performed with a magnetisation-prepared rapid gradient-echo sequence (TR=2400 ms, TE=2.36 ms, TI=1000 ms, flip angle=8°, slice thickness=0.8 mm).…”

Spring cleaning: time to rethink imaging research lines in MS?

“…On the other hand, spinal cord damage parallels accumulation of motor disability [104, 105]. Optimized segmentation techniques have led to more and more reliable volumetric measures of these clinically meaningful structures [106, 107], and introducing them into the clinical practice seems to be the most reasonable approach, so far. Similarly, among the tractography-reconstructed WM fiber bundles [108], efforts should be spent to move into everyday clinical practice the imaging of a few clinically relevant tracts, such as the pyramidal tract and visual pathway – perhaps in conjunction with other imaging modalities such as optical coherence tomography [109–113].…”