Abstract Details

Title Instrumental, Clinical, and Patient Reported Sensorimotor Correlates of Spinal Cord Grey and Total Cord Areas

Topic Multiple Sclerosis

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-042

Objective To assess differences in the relationships between cord grey and white matter areas with methods practiced to quantify loss of function in patients with Multiple Sclerosis(MS), a cohort of patients and healthy controls received magnetic resonance imaging(MRI) and neurological function assessments from three perspectives: physician evaluations using traditional methods(P), questionnaires on patient-interpreted disability(Q); exams using sensorimotor instruments(I).

Background

Traditionally, sensorimotor function has not been well associated with brain MRI lesions and atrophy measurements. However, spinal cord atrophy has been shown to correlate well with MS disability.

Design/Methods 50 MS patients (23 men,27 women) plus 10 healthy controls, aged 18-70 years, underwent MRI scans including an axial PSIR scan of the C2-C3 cervical spine. The cord images were segmented using Jim 7.0 to calculate a total cord area(TCA) and grey matter area(GMA). The physician evaluation metrics included the EDSS(Expanded Disability Status Scale), 25-ft walk time and 9-hole peg test(9HPT). Questionnaires included Patient Reported EDSS(PREDSS), Ambulatory Index(AI), Disability Scale, Neurological Rating Scale, Functional Scale, Walking Assistance, and WHODAS. Instrumental exams employed the microFET-neck/arm strength dynamometer, Vibratron multi-frequency sensitivity tester (VMST), and Jamar grip dynamometer. Correlations between cord areas and each functional metric were computed with adjustment for disease duration and sex. LASSO regression models were made separately for each class of functional metrics to select models that predicted cord areas and include all variables.

Results Disease duration and all classes of functional metrics predicted TCA and GMA to a similar degree: TCA-R²=29%(P),29%(Q),34%(I);GMA-R²= 36%(P);42%(Q);42%(I). Only 9HPT(P), PREDSS(Q), and FET-neck and VMST(I) were selected for these models. For correlations of functional metrics with cord areas adjusted for sex(TCA-p=0.097;GMA-p=ns) and disease duration(TCA-p=0.004;GMA-p=0.0087), instrumental variables(VMST TCA-p=ns,GMA-p=0.0043;FET-neck TCA-p=<0.0001,GMA-p=0.0014;Grip TCA-p=0.0004,GMA p=0.018), PREDSS (TCA-p=0.0002, GMA-p=0.001), and 9HPT(TCA-p=0.008,GMA-p=0.0081) showed top correlations.

Conclusions In comparison, instrumental exams(FET-neck,VMST) best predicted total and grey matter spinal cord findings. However, patient questionnaires(PREDSS,AI) also correlate with MRI findings.

Authors/Disclosures
Amber M. Alexander PRESENTER	Amber M. Alexander has nothing to disclose.
Jennifer Arjona	No disclosure on file
Nico Papinutto	No disclosure on file
William Stern	No disclosure on file
Antje Bischof, MD	Dr. Bischof has nothing to disclose.
Valerie A. Block, DPTSc (University of California, San Francisco)	Dr. Block has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. The institution of Dr. Block has received research support from National MS Society.
Jeffrey M. Gelfand, MD, MS, FAAN (University of California, San Francisco)	Dr. Gelfand has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Arialys. Dr. Gelfand has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ventyx Bio. An immediate family member of Dr. Gelfand has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Headache: The Journal of Head and Face Pain. The institution of Dr. Gelfand has received research support from Genentech/Roche. The institution of Dr. Gelfand has received research support from Vigil Neurosciences. An immediate family member of Dr. Gelfand has received publishing royalties from a publication relating to health care. Dr. Gelfand has received publishing royalties from a publication relating to health care. Dr. Gelfand has received publishing royalties from a publication relating to health care. Dr. Gelfand has a non-compensated relationship as a Trial Steering Committee Chairperson and member with Roche / Genentech that is relevant to AAN interests or activities.
Douglas S. Goodin, MD (Univ of Calif at San Francisco)	No disclosure on file
Xiaoming Jia, MD, MEng (Genentech)	Dr. Jia has received personal compensation for serving as an employee of Genentech/Roche. Dr. Jia has stock in Roche.
Andrew R. Romeo, MD (University of Michigan)	No disclosure on file
Jennifer Graves, MD, PhD (UCSD)	Dr. Graves has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Graves has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Graves has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MSJ. The institution of Dr. Graves has received research support from Octave. The institution of Dr. Graves has received research support from Sanofi. The institution of Dr. Graves has received research support from EMD Serono.
Bruce A. Cree, MD, PhD, MAS, FAAN (UCSF, Multiple Sclerosis Center)	The institution of Dr. Cree has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. The institution of Dr. Cree has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. The institution of Dr. Cree has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. The institution of Dr. Cree has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for TG Therapeutics. The institution of Dr. Cree has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Cree has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neuron23. Dr. Cree has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Pharma. Dr. Cree has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Hexal/Sandoz. Dr. Cree has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunic AG. The institution of Dr. Cree has received research support from Genentech. The institution of Dr. Cree has received research support from Kyverna. Dr. Cree has received publishing royalties from a publication relating to health care.
Stephen L. Hauser, MD (UCSF Weill Institute for Neurosciences)	Dr. Hauser has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NGM Bio. Dr. Hauser has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Moderna. Dr. Hauser has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BD. Dr. Hauser has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pheno Therapeutics. Dr. Hauser has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Nurix Therapeutics. Dr. Hauser has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gilead. Dr. Hauser has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Accure. Dr. Hauser has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alector. Dr. Hauser has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hinge Therapeutics. Dr. Hauser has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Neurona. Dr. Hauser has a non-compensated relationship as a Clinical Trial/Primary Investigator with Roche that is relevant to AAN interests or activities. Dr. Hauser has a non-compensated relationship as a Clinical Trial/Primary Investigator with Novartis that is relevant to AAN interests or activities.
Roland G. Henry, PhD (University of California, San Francisco)	Dr. Henry has received personal compensation in the range of $500-$4,999 for serving as a Consultant for MEDDAY. Dr. Henry has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Henry has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Henry has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi/Genzyme.

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