scholarly journals Sensitive Detection of Infratentorial and Upper Cervical Cord Lesions in Multiple Sclerosis with Combined 3D FLAIR and T2-Weighted (FLAIR3) Imaging

2020 ◽  
Vol 41 (11) ◽  
pp. 2062-2067
Author(s):  
R.E. Gabr ◽  
J.A. Lincoln ◽  
A. Kamali ◽  
O. Arevalo ◽  
X. Zhang ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Sensitive Detection ◽  
Cervical Cord ◽  
Upper Cervical ◽  
3D Flair

Atrophy and structural variability of the upper cervical cord in early multiple sclerosis

2014 ◽  
Vol 21 (7) ◽  
pp. 875-884 ◽  
Author(s):  
Viola Biberacher ◽  
Christine C Boucard ◽  
Paul Schmidt ◽  
Christina Engl ◽  
Dorothea Buck ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Brain Magnetic Resonance Imaging ◽  
Cervical Cord ◽  
Focal Lesions ◽  
Spinal Cord Atrophy ◽  
Cross Sectional ◽  
Structural Variability ◽  
Upper Cervical ◽  
In Cis

Background: Despite agreement about spinal cord atrophy in progressive forms of multiple sclerosis (MS), data on clinically isolated syndrome (CIS) and relapsing–remitting MS (RRMS) are conflicting. Objective: To determine the onset of spinal cord atrophy in the disease course of MS. Methods: Structural brain magnetic resonance imaging (MRI) was acquired from 267 patients with CIS (85) or RRMS (182) and 64 healthy controls (HCs). The upper cervical cord cross-sectional area (UCCA) was determined at the level of C2/C3 by a segmentation tool and adjusted for focal MS lesions. The coefficient of variation (CV) was calculated from all measurements between C2/C3 and 13 mm above as a measure of structural variability. Results: Compared to HCs (76.1±6.9 mm2), UCCA was significantly reduced in CIS patients (73.5±5.8 mm2, p=0.018) and RRMS patients (72.4±7.0 mm2, p<0.001). Structural variability was higher in patients than in HCs, particularly but not exclusively in case of focal lesions (mean CV HCs/patients without/with lesions: 2.13%/2.55%/3.32%, all p-values<0.007). UCCA and CV correlated with Expanded Disability Status Scale (EDSS) scores ( r =−0.131/0.192, p=0.044/<0.001) and disease duration ( r=−0.134/0.300, p=0.039/< 0.001). CV additionally correlated with hand and arm function ( r=0.180, p=0.014). Conclusion: In MS, cervical cord atrophy already occurs in CIS. In early stages, structural variability may be a more meaningful marker of spinal cord pathology than atrophy.

scholarly journals Association of iron rim lesions with brain and cervical cord volume in relapsing multiple sclerosis

2021 ◽  
Author(s):  
Claudia E. Weber ◽  
Julia Krämer ◽  
Matthias Wittayer ◽  
Johannes Gregori ◽  
Sigurd Randoll ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Grey Matter ◽  
Cervical Cord ◽  
Cross Sectional ◽  
Upper Cervical ◽  
Cortical Grey Matter ◽  
Multiple Sclerosis Patients ◽  
Brain And Spinal Cord

Abstract Objectives In multiple sclerosis (MS), iron rim lesions (IRLs) are indicators of chronic low-grade inflammation and ongoing tissue destruction. The aim of this study was to assess the relationship of IRLs with clinical measures and magnetic resonance imaging (MRI) markers, in particular brain and cervical cord volume. Methods Clinical and MRI parameters from 102 relapsing MS patients (no relapses for at least 6 months, no contrast-enhancing lesions) were included; follow-up data obtained after 12 months was available in 49 patients. IRLs were identified on susceptibility-weighted images (SWIs). In addition to standard brain and spinal cord MRI parameters, normalised cross-sectional area (nCSA) of the upper cervical cord was calculated. Results Thirty-eight patients had at least one IRL on SWI MRI. At baseline, patients with IRLs had higher EDSS scores, higher lesion loads (brain and spinal cord), and lower cortical grey matter volumes and a lower nCSA. At follow-up, brain atrophy rates were higher in patients with IRLs. IRLs correlated spatially with T1-hypointense lesions. Conclusions Relapsing MS patients with IRLs showed more aggressive MRI disease characteristics in both the cross-sectional and longitudinal analyses. Key Points • Multiple sclerosis patients with iron rim lesions had higher EDSS scores, higher brain and spinal cord lesion loads, lower cortical grey matter volumes, and a lower normalised cross-sectional area of the upper cervical spinal cord. • Iron rim lesions are a new lesion descriptor obtained from susceptibility-weighted MRI. Our data suggests that further exploration of this lesion characteristic in regard to a poorer prognosis in multiple sclerosis patients is warranted.

Balance deficit with opened or closed eyes reveals involvement of different structures of the central nervous system in multiple sclerosis

2013 ◽  
Vol 20 (1) ◽  
pp. 81-90 ◽  
Author(s):  
Luca Prosperini ◽  
Nikolaos Petsas ◽  
Eytan Raz ◽  
Emilia Sbardella ◽  
Francesca Tona ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Center Of Pressure ◽  
Cervical Cord ◽  
Cross Sectional ◽  
Upper Cervical ◽  
The Central Nervous System ◽  
Balance Deficit

Objective: To evaluate whether balance deficit in patients with multiple sclerosis (MS), as assessed with eyes opened (EO) and closed (EC), is associated with damage of different structures of the central nervous system (CNS). Methods: Fifty patients with MS and 20 healthy controls (HCs) underwent static posturography to calculate the body’s center of pressure displacement (COP path) with EO and EC. They were scanned using a 3.0T magnet to obtain PD/T2 and 3D-T1-weighted images of the brain and spinal cord. We determined the mid-sagittal cerebellum area (MSCA) and upper cervical cord cross-sectional area (UCCA). We also measured the patients’ lesion volumes (T2-LVs) on the whole brain and at different infratentorial levels. Results: MS patients had wider COP paths with both EO and EC ( p < 0.001), and lower values in both MSCA ( p = 0.01) and UCCA ( p = 0.008) than HCs. The COP path with EO was associated with MSCA (Beta = − 0.58; p = 0.004) and T2-LV on middle cerebellar peduncles (Beta = 0.59; p = 0.002). The COP path with EC was associated with UCCA (Beta= − 22.74; p = 0.003) and brainstem T2-LV (Beta = 0.52; p = 0.01). Conclusions: Balance deficit in MS was related to atrophy of both the cerebellum and spinal cord, but the extent of COP path under the two different conditions (EO or EC) implied different patterns of damage in the CNS.

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

2014 ◽  
Vol 20 (14) ◽  
pp. 1860-1865 ◽  
Author(s):  
Marita Daams ◽  
Florian Weiler ◽  
Martijn D Steenwijk ◽  
Horst K Hahn ◽  
Jeroen JG Geurts ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Brain Magnetic Resonance Imaging ◽  
Cervical Cord ◽  
Healthy Controls ◽  
Spinal Cord Atrophy ◽  
Disability Status ◽  
Upper Cervical ◽  
Male Patients ◽  
Magnetic Resonance Imaging Mri

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.

scholarly journals Cervical cord myelin abnormality is associated with clinical disability in multiple sclerosis

2021 ◽  
pp. 135245852110017
Author(s):  
Lisa Eunyoung Lee ◽  
Irene M Vavasour ◽  
Adam Dvorak ◽  
Hanwen Liu ◽  
Shawna Abel ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Progressive Multiple Sclerosis ◽  
Dorsal Column ◽  
Cervical Cord ◽  
In Vivo Measurement ◽  
Subclinical Disease ◽  
Healthy Control ◽  
Magnetic Resonance Imaging Mri ◽  
Relapsing Remitting Multiple Sclerosis

Background: Myelin water imaging (MWI) was recently optimized to provide quantitative in vivo measurement of spinal cord myelin, which is critically involved in multiple sclerosis (MS) disability. Objective: To assess cervical cord myelin measurements in relapsing-remitting multiple sclerosis (RRMS) and progressive multiple sclerosis (ProgMS) participants and evaluate the correlation between myelin measures and clinical disability. Methods: We used MWI data from 35 RRMS, 30 ProgMS, and 28 healthy control (HC) participants collected at cord level C2/C3 on a 3 T magnetic resonance imaging (MRI) scanner. Myelin heterogeneity index (MHI), a measurement of myelin variability, was calculated for whole cervical cord, global white matter, dorsal column, lateral and ventral funiculi. Correlations were assessed between MHI and Expanded Disability Status Scale (EDSS), 9-Hole Peg Test (9HPT), timed 25-foot walk, and disease duration. Results: In various regions of the cervical cord, ProgMS MHI was higher compared to HC (between 9.5% and 31%, p ⩽ 0.04) and RRMS (between 13% and 26%, p ⩽ 0.02), and ProgMS MHI was associated with EDSS ( r = 0.42–0.52) and 9HPT ( r = 0.45–0.52). Conclusion: Myelin abnormalities within clinically eloquent areas are related to clinical disability. MWI metrics have a potential role for monitoring subclinical disease progression and adjudicating treatment efficacy for new therapies targeting ProgMS.

scholarly journals *Autopsy of a suspected venous circulatory disturbance localized in the medulla oblongata and upper cervical cord accompanied with an aneurysm

2008 ◽  
Vol 48 (8) ◽  
pp. 568-574
Author(s):  
Katsuhisa Masaki ◽  
Masaharu Ohno ◽  
Hironobu Maeda ◽  
Tetsuo Hamada ◽  
Toru Iwaki ◽  
...  
Keyword(s):  
Medulla Oblongata ◽  
Cervical Cord ◽  
Circulatory Disturbance ◽  
Upper Cervical
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