Cervical cord myelin abnormality is associated with clinical disability in multiple sclerosis. (December 2021)

• Record Type: Journal Article
• Authors: Lee, Lisa Eunyoung; Vavasour, Irene M; Dvorak, Adam; Liu, Hanwen; Abel, Shawna; Johnson, Poljanka; Ristow, Stephen; Au, Shelly; Laule, Cornelia; Tam, Roger; Li, David KB; Cross, Helen; Ackermans, Nathalie; Schabas, Alice J; Chan, Jillian; Sayao, Ana-Luiza; Devonshire, Virginia; Carruthers, Robert; Traboulsee, Anthony; Kolind, Shannon
• Is Part Of: Multiple sclerosis. Volume 27:Number 14(2021)
• Page Start: 2191
• Page End: 2198
• Publication Date: 2021-12
• Subjects: Multiple sclerosis -- spinal cord -- magnetic resonance imaging -- quantitative MRI -- myelin water imaging -- demyelination; Central nervous system -- Diseases -- Periodicals; Myelin sheath -- Diseases -- Periodicals; Inflammation -- Periodicals; Multiple sclerosis -- Periodicals; Central Nervous System Diseases -- Periodicals; Demyelinating Diseases -- Periodicals; Inflammation -- Periodicals; Multiple Sclerosis -- Periodicals; Système nerveux central -- Maladies -- Périodiques; Gaine de myéline -- Maladies -- Périodiques; Inflammation (Pathologie) -- Périodiques; Sclérose en plaques -- Périodiques; Electronic journals; 616.834005
• DOI: 10.1177/13524585211001780
• Languages: English
• ISSNs: 1352-4585

Abstract

Background: Myelin water imaging (MWI) was recently optimized to provide quantitative in vivo measurement of spinal cord myelin, which is critically involved in multiple sclerosis (MS) disability. Objective: To assess cervical cord myelin measurements in relapsing-remitting multiple sclerosis (RRMS) and progressive multiple sclerosis (ProgMS) participants and evaluate the correlation between myelin measures and clinical disability. Methods: We used MWI data from 35 RRMS, 30 ProgMS, and 28 healthy control (HC) participants collected at cord level C2/C3 on a 3 T magnetic resonance imaging (MRI) scanner. Myelin heterogeneity index (MHI), a measurement of myelin variability, was calculated for whole cervical cord, global white matter, dorsal column, lateral and ventral funiculi. Correlations were assessed between MHI and Expanded Disability Status Scale (EDSS), 9-Hole Peg Test (9HPT), timed 25-foot walk, and disease duration. Results: In various regions of the cervical cord, ProgMS MHI was higher compared to HC (between 9.5% and 31%, p ⩽ 0.04) and RRMS (between 13% and 26%, p ⩽ 0.02), and ProgMS MHI was associated with EDSS ( r = 0.42–0.52) and 9HPT ( r = 0.45–0.52). Conclusion: Myelin abnormalities within clinically eloquent areas are related to clinical disability. MWI metrics have a potential role for monitoring subclinical disease progression and adjudicating treatment efficacy for new therapies targeting ProgMS.