A multicenter assessment of cervical cord atrophy among MS clinical phenotypes

M. A. Rocca, M. A. Horsfield, S. Sala, M. Copetti, P. Valsasina, S. Mesaros, V. Martinelli, D. Caputo, T. Stosic-Opincal, J. Drulovic, G. Comi, M. Filippi

Research output: Contribution to journalArticle

Abstract

ObjectiveIn this multicenter study, a new semiautomatic method for segmenting the cervical cord from C2 to C5 was used to investigate the correlation between cord atrophy and clinical disability in a large sample of patients with multiple sclerosis (MS). Methods: T2 and 3-dimensional T1-weighted cervical cord scans and dual-echo brain scans were acquired from 143 healthy controls, 22 patients with clinically isolated syndromes (CIS), 101 patients with relapsing-remitting MS (RRMS), 79 patients with secondary progressive MS (SPMS), 58 patients with benign MS (BMS), and 75 patients with primary progressive MS (PPMS) in 3 European centers. Normalized cervical cord cross-sectional area (CSAn) was measured by an active surface cord model. Between-group comparisons were performed using linear mixed-effect models. A nonparametric kernel estimator was used to obtain smoothed plots of CSA along the cervical cord. Results: Cord CSAn was significantly lower in PPMS vs healthy controls, BMS vs RRMS, SPMS vs BMS, and RRMS. From C2 to C5, a net separation and definition of the plots of patients with BMS, PPMS, and SPMS was seen with respect to those of the other study groups. CSAn was correlated with Expanded Disability Status Scale (r = -0.49, p <0.0001), with a differential effect among disease clinical phenotypes: no association in either CIS or in BMS; association in RRMS (r = -0.30, p = 0.001), SPMS (r = -0.34, p = 0.001), and PPMS (r = -0.27, p = 0.01). Conclusions: Cervical cord atrophy provides a relevant and useful marker for the characterization of clinical heterogeneity of patients with MS. The stability of this measure among different centers supports its use as potential outcome measure to monitor disease progression in multicenter trials.

Original languageEnglish
Pages (from-to)2096-2102
Number of pages7
JournalNeurology
Volume76
Issue number24
DOIs
Publication statusPublished - Jun 14 2011

Fingerprint

Multiple Sclerosis
Atrophy
Phenotype
Chronic Progressive Multiple Sclerosis
Multicenter Studies
Relapsing-Remitting Multiple Sclerosis
Cervical Cord
Disease Progression
Biomarkers
Outcome Assessment (Health Care)
Brain

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

A multicenter assessment of cervical cord atrophy among MS clinical phenotypes. / Rocca, M. A.; Horsfield, M. A.; Sala, S.; Copetti, M.; Valsasina, P.; Mesaros, S.; Martinelli, V.; Caputo, D.; Stosic-Opincal, T.; Drulovic, J.; Comi, G.; Filippi, M.

In: Neurology, Vol. 76, No. 24, 14.06.2011, p. 2096-2102.

Research output: Contribution to journalArticle

Rocca, MA, Horsfield, MA, Sala, S, Copetti, M, Valsasina, P, Mesaros, S, Martinelli, V, Caputo, D, Stosic-Opincal, T, Drulovic, J, Comi, G & Filippi, M 2011, 'A multicenter assessment of cervical cord atrophy among MS clinical phenotypes', Neurology, vol. 76, no. 24, pp. 2096-2102. https://doi.org/10.1212/WNL.0b013e31821f46b8
Rocca, M. A. ; Horsfield, M. A. ; Sala, S. ; Copetti, M. ; Valsasina, P. ; Mesaros, S. ; Martinelli, V. ; Caputo, D. ; Stosic-Opincal, T. ; Drulovic, J. ; Comi, G. ; Filippi, M. / A multicenter assessment of cervical cord atrophy among MS clinical phenotypes. In: Neurology. 2011 ; Vol. 76, No. 24. pp. 2096-2102.
@article{729874a6fc824d49ae67b638218e7ff8,
title = "A multicenter assessment of cervical cord atrophy among MS clinical phenotypes",
abstract = "ObjectiveIn this multicenter study, a new semiautomatic method for segmenting the cervical cord from C2 to C5 was used to investigate the correlation between cord atrophy and clinical disability in a large sample of patients with multiple sclerosis (MS). Methods: T2 and 3-dimensional T1-weighted cervical cord scans and dual-echo brain scans were acquired from 143 healthy controls, 22 patients with clinically isolated syndromes (CIS), 101 patients with relapsing-remitting MS (RRMS), 79 patients with secondary progressive MS (SPMS), 58 patients with benign MS (BMS), and 75 patients with primary progressive MS (PPMS) in 3 European centers. Normalized cervical cord cross-sectional area (CSAn) was measured by an active surface cord model. Between-group comparisons were performed using linear mixed-effect models. A nonparametric kernel estimator was used to obtain smoothed plots of CSA along the cervical cord. Results: Cord CSAn was significantly lower in PPMS vs healthy controls, BMS vs RRMS, SPMS vs BMS, and RRMS. From C2 to C5, a net separation and definition of the plots of patients with BMS, PPMS, and SPMS was seen with respect to those of the other study groups. CSAn was correlated with Expanded Disability Status Scale (r = -0.49, p <0.0001), with a differential effect among disease clinical phenotypes: no association in either CIS or in BMS; association in RRMS (r = -0.30, p = 0.001), SPMS (r = -0.34, p = 0.001), and PPMS (r = -0.27, p = 0.01). Conclusions: Cervical cord atrophy provides a relevant and useful marker for the characterization of clinical heterogeneity of patients with MS. The stability of this measure among different centers supports its use as potential outcome measure to monitor disease progression in multicenter trials.",
author = "Rocca, {M. A.} and Horsfield, {M. A.} and S. Sala and M. Copetti and P. Valsasina and S. Mesaros and V. Martinelli and D. Caputo and T. Stosic-Opincal and J. Drulovic and G. Comi and M. Filippi",
year = "2011",
month = "6",
day = "14",
doi = "10.1212/WNL.0b013e31821f46b8",
language = "English",
volume = "76",
pages = "2096--2102",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "24",

}

TY - JOUR

T1 - A multicenter assessment of cervical cord atrophy among MS clinical phenotypes

AU - Rocca, M. A.

AU - Horsfield, M. A.

AU - Sala, S.

AU - Copetti, M.

AU - Valsasina, P.

AU - Mesaros, S.

AU - Martinelli, V.

AU - Caputo, D.

AU - Stosic-Opincal, T.

AU - Drulovic, J.

AU - Comi, G.

AU - Filippi, M.

PY - 2011/6/14

Y1 - 2011/6/14

N2 - ObjectiveIn this multicenter study, a new semiautomatic method for segmenting the cervical cord from C2 to C5 was used to investigate the correlation between cord atrophy and clinical disability in a large sample of patients with multiple sclerosis (MS). Methods: T2 and 3-dimensional T1-weighted cervical cord scans and dual-echo brain scans were acquired from 143 healthy controls, 22 patients with clinically isolated syndromes (CIS), 101 patients with relapsing-remitting MS (RRMS), 79 patients with secondary progressive MS (SPMS), 58 patients with benign MS (BMS), and 75 patients with primary progressive MS (PPMS) in 3 European centers. Normalized cervical cord cross-sectional area (CSAn) was measured by an active surface cord model. Between-group comparisons were performed using linear mixed-effect models. A nonparametric kernel estimator was used to obtain smoothed plots of CSA along the cervical cord. Results: Cord CSAn was significantly lower in PPMS vs healthy controls, BMS vs RRMS, SPMS vs BMS, and RRMS. From C2 to C5, a net separation and definition of the plots of patients with BMS, PPMS, and SPMS was seen with respect to those of the other study groups. CSAn was correlated with Expanded Disability Status Scale (r = -0.49, p <0.0001), with a differential effect among disease clinical phenotypes: no association in either CIS or in BMS; association in RRMS (r = -0.30, p = 0.001), SPMS (r = -0.34, p = 0.001), and PPMS (r = -0.27, p = 0.01). Conclusions: Cervical cord atrophy provides a relevant and useful marker for the characterization of clinical heterogeneity of patients with MS. The stability of this measure among different centers supports its use as potential outcome measure to monitor disease progression in multicenter trials.

AB - ObjectiveIn this multicenter study, a new semiautomatic method for segmenting the cervical cord from C2 to C5 was used to investigate the correlation between cord atrophy and clinical disability in a large sample of patients with multiple sclerosis (MS). Methods: T2 and 3-dimensional T1-weighted cervical cord scans and dual-echo brain scans were acquired from 143 healthy controls, 22 patients with clinically isolated syndromes (CIS), 101 patients with relapsing-remitting MS (RRMS), 79 patients with secondary progressive MS (SPMS), 58 patients with benign MS (BMS), and 75 patients with primary progressive MS (PPMS) in 3 European centers. Normalized cervical cord cross-sectional area (CSAn) was measured by an active surface cord model. Between-group comparisons were performed using linear mixed-effect models. A nonparametric kernel estimator was used to obtain smoothed plots of CSA along the cervical cord. Results: Cord CSAn was significantly lower in PPMS vs healthy controls, BMS vs RRMS, SPMS vs BMS, and RRMS. From C2 to C5, a net separation and definition of the plots of patients with BMS, PPMS, and SPMS was seen with respect to those of the other study groups. CSAn was correlated with Expanded Disability Status Scale (r = -0.49, p <0.0001), with a differential effect among disease clinical phenotypes: no association in either CIS or in BMS; association in RRMS (r = -0.30, p = 0.001), SPMS (r = -0.34, p = 0.001), and PPMS (r = -0.27, p = 0.01). Conclusions: Cervical cord atrophy provides a relevant and useful marker for the characterization of clinical heterogeneity of patients with MS. The stability of this measure among different centers supports its use as potential outcome measure to monitor disease progression in multicenter trials.

UR - http://www.scopus.com/inward/record.url?scp=79959630427&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79959630427&partnerID=8YFLogxK

U2 - 10.1212/WNL.0b013e31821f46b8

DO - 10.1212/WNL.0b013e31821f46b8

M3 - Article

C2 - 21670439

AN - SCOPUS:79959630427

VL - 76

SP - 2096

EP - 2102

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 24

ER -