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Abstract Details

Spinal Cord Atrophy in Neuromyelitis Optica Is Associated to Spinal Cord Lesions and Clinical Disability
Multiple Sclerosis
P1 - Poster Session 1 (5:30 PM-6:30 PM)
15-071
To characterize the spatial distribution of spinal cord atrophy in Neuromyelitis Optica (NMO) patients, its relation with cord T1-hypointense lesions and their correlation with clinical disability.
Spinal cord lesions are one of the main MRI finding in NMO. With the recent introduction of high field scanners and optimized sequences, cord T1-hypointense lesions have become highly detectable. 

Cord 3D T1-weighted scans were acquired from 40 NMO patients and 15 age- and sex-matched healthy controls (HC). After identifying cord T1-hypointense lesions, binary lesion masks were produced. The active surface (AS) method was applied to calculate cross-sectional area (CSA) of cervical and upper portion of the dorsal cord (until D3). On the basis of active surfaces, a voxel-wise assessment of T1-weighted hypointense lesion probability maps (LPM) was performed and cord atrophy was compared between groups.
All NMO were aquaporine4-positive and 26/40 (65%) had T1-hypointense cord lesions. LPM showed a predominant involvement of the upper cervical cord (C3-C4, 20%) and upper thoracic cord (D1, 20%), with a central distribution of lesions on the axial slices. In NMO, cord atrophy was in the anterior and posterior columns with a significant damage at C3-C4 (p<0.001) and D1 (p<0.01) segments and co-localized with focal cord lesions. Both cord T1-hypointense lesions and atrophy correlated with Expanded Disability Status Scale (EDSS) at cervical level (p<0.01). Pyramidal and sensitive EDSS subscores correlated with atrophy at lower cervical and upper thoracic level (p<0.01). NMO patients without spinal cord lesions had no significant cord atrophy compared to HC.
In NMO there is evidence of focal areas of spinal cord atrophy, corresponding to regions of higher lesional involvement. Such an evidence suggests the existence in this condition of a focal, inflammatory-driven mechanism of damage rather than a primary neurodegenerative and diffuse process.
Authors/Disclosures
Laura Cacciaguerra, MD, PhD (Mayo Clinic)
PRESENTER 		Dr. Cacciaguerra has nothing to disclose.
Paola Valsasina Paola Valsasina has nothing to disclose.
Sarlota Mesaros Sarlota Mesaros has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Sarlota Mesaros has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Astra Zeneca. Sarlota Mesaros has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Novartis. Sarlota Mesaros has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Hemofarm. Sarlota Mesaros has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck.
Jelena Drulovic Jelena Drulovic has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck . Jelena Drulovic has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Jelena Drulovic has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Jelena Drulovic has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hemofarm. Jelena Drulovic has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for PharmaSwiss. Jelena Drulovic has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck . Jelena Drulovic has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Jelena Drulovic has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Actavis TEVA. Jelena Drulovic has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Jelena Drulovic has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Hemofarm. Jelena Drulovic has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Medis. Jelena Drulovic has received research support from Ministry of Science, Technological Development and Innovations of the Republic of Serbia.
Alessandro Meani Alessandro Meani has nothing to disclose.
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit) Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Maria A. Rocca (Neuroimaging Research Unit) Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen, Bristol Myers Squibb, Eli Lilly, Janssen, Roche. Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for AstraZaneca, Biogen, Bristol Myers Squibb, Bromatech, Celgene, Genzyme, Horizon Therapeutics Italy, Merck Serono SpA, Novartis, Roche, Sanofi and Teva. The institution of Maria Assunta Rocca has received research support from MS Society of Canada, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.