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Mult Scler. 2014 Dec;20(14):1860-5. doi: 10.1177/1352458514533399. Epub 2014 May 8.

Mean upper cervical cord area (MUCCA) measurement in long-standing multiple sclerosis: relation to brain findings and clinical disability.

Author information

1
VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands m.daams@vumc.nl.
2
Fraunhofer MEVIS, Institute for Medical Image Computing, Bremen, Germany.
3
Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
4
Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands/ Mayo Clinic, Rochester, MN, USA.

Abstract

BACKGROUND:

The majority of patients with multiple sclerosis (MS) present with spinal cord pathology. Spinal cord atrophy is thought to be a marker of disease severity, but in long-disease duration its relation to brain pathology and clinical disability is largely unknown.

OBJECTIVE:

Our aim was to investigate mean upper cervical cord area (MUCCA) in patients with long-standing MS and assess its relation to brain magnetic resonance imaging (MRI) measures and clinical disability.

METHODS:

MUCCA was measured in 196 MS patients and 55 healthy controls using 3DT1-weighted cervical images obtained at 3T MRI. Clinical disability was measured using the Expanded Disability Status Scale (EDSS), Nine-Hole-Peg test (9-HPT), and 25 feet Timed Walk Test (TWT). Stepwise linear regression was performed to assess the association between MUCCA and MRI measures, and between MUCCA and clinical disability.

RESULTS:

MUCCA was smaller (mean 11.7%) in MS patients compared with healthy controls (72.56±9.82 and 82.24±7.80 mm2 respectively; p<0.001), most prominently in male patients. MUCCA was associated with normalized brain volume, and number of cervical cord lesions. MUCCA was independently associated with EDSS, TWT, and 9-HPT.

CONCLUSION:

MUCCA was reduced in MS patients compared with healthy controls. It provides a relevant marker for clinical disability in long-standing disease, independent of other MRI measures.

KEYWORDS:

Multiple sclerosis; atrophy; disability evaluation; magnetic resonance imaging; spinal cord

PMID:
24812042
DOI:
10.1177/1352458514533399
[Indexed for MEDLINE]

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