Abstract Details

Title Influence of T2-Hyperintense Lesions on Cervical Spinal Cord Atrophy and Disability in Patients with Multiple Sclerosis

Topic Multiple Sclerosis

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

Poster/Presentation
Number 15-052

Objective To assess the influence of brain, cervical spinal cord (CSC) and thoracic spinal cord (TSC) T2-hyperintense lesions on CSC atrophy in patients with multiple sclerosis (MS). Relationships with patients’ disability were also investigated.

Background

The mechanisms associated to cervical cord atrophy in MS are poorly understood.

Design/Methods

Thirty-four MS patients (28 relapsing-remitting and 6 progressive MS) underwent brain, cervical and thoracic spinal cord MRI at 3T, and expanded disability status scale (EDSS) score assessment. Sagittal dual-echo scans and axial multi-echo images were used to assess T2-hyperintense lesion volume (T2 LV) and count (T2 LC) of the cervical and thoracic spinal cord segments. Brain T2 LV was obtained from axial dual echo images. 3D T1-weighted scans were employed to assess the normalized whole CSC cross-sectional area (CSAn) using an active surface method. Age- and sex-adjusted multiple regression models were used to assess univariate correlations of brain and cord T2 LVs/LCs with CSAn and EDSS. The same modelling was then used to identify the variables independently associated with CSAn and EDSS using a stepwise variable selection.

Results CSAn was associated with CSC T2 LV (β=-036, p=0.03), but not with TSC (p=0.5) or brain (p=0.2) T2 LV. The same analysis showed a significant association between EDSS and CSC T2 LV (β=0.42, p=0.01) and brain T2 LV (β=0.34, p=0.04), and a trend towards an association with TSC LC (β=0.30, p=0.07). The multivariable regression analyses retained age, sex and CSC T2 LV as significant predictors of CSAn (explained variance=20%, p=0.023) and EDSS score (explained variance=31%, p=0.004).

Conclusions CSC atrophy was associated with CSC T2 LV, suggesting an effect of secondary degenerative processes on CSC atrophy development. The overall CNS T2 lesion burden was more tightly correlated than CSC atrophy to the disability status of our patients.

Authors/Disclosures
Maria A. Rocca (Neuroimaging Research Unit) PRESENTER	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.
Paolo Preziosa (Ospedale San Raffaele)	Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb . Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi Genzyme. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck.
	No disclosure on file
Paola Valsasina	Paola Valsasina has nothing to disclose.
Claudio Gobbi, MD (Ospedale Regionale Lugano)	Dr. Gobbi has nothing to disclose.
Chiara Zecca, MD (Ente ospedaliero cantonale)	Prof. Zecca 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.

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