Relationships between quantitative spinal cord MRI and retinal layers in multiple sclerosis

Jiwon Oh, Elias S. Sotirchos, Shiv Saidha, Anna Whetstone, Min Chen, Scott Newsome, Kathy Zackowski, Laura J. Balcer, Elliot Frohman, Jerry Ladd Prince, Marie Diener-West, Daniel S. Reich, Peter Calabresi

Research output: Contribution to journalArticle

Abstract

Objective: To assess relationships between spinal cord MRI (SC-MRI) and retinal measures, and to evaluate whether these measures independently relate to clinical disability inmultiple sclerosis (MS). Methods: One hundred two patients with MS and 11 healthy controls underwent 3-tesla brain and cervical SC-MRI, which included standard T1- and T2-based sequences and diffusion-tensor and magnetization-transfer imaging, and optical coherence tomography with automated segmentation. Clinical assessments included visual acuity (VA), Expanded Disability Status Scale, MS functional composite, vibration sensation threshold, and hip-flexion strength. Regions of interest circumscribing SC cross-sections at C3-4 were used to obtain cross-sectional area (CSA), fractional anisotropy (FA), perpendicular diffusivity (λ), and magnetization transfer ratio. Multivariable regression assessed group differences and SC, retinal, and clinical relationships. Results: In MS, there were correlations between SC-CSA, SC-FA, SC-λ, and peripapillary retinal nerve fiber layer (pRNFL) (p = 0.01, p = 0.002, p = 0.001, respectively) after adjusting for age, sex, prior optic neuritis, and brain atrophy. In multivariable clinical models, when SC-CSA, pRNFL, and brain atrophy were included simultaneously, SC-CSA and pRNFL retained independent relationships with low-contrast VA (p = 0.04, p = 0.002, respectively), high-contrast VA (p = 0.06, p = 0.008), and vibration sensation threshold (p = 0.01, p = 0.05). SC-CSA alone retained independent relationships with Expanded Disability Status Scale (p = 0.001), hip-flexion strength (p = 0.001), and MS functional composite (p = 0.004). Conclusions: In this cross-sectional study of patients with MS, correlations exist between SC-MRI and retinal layers, and both exhibit independent relationships with clinical dysfunction. These findings suggest that the SC and optic nerve reflect ongoing global pathologic processes that supplement measures of whole-brain atrophy, highlighting the importance of combining measures from unique compartments to facilitate a thorough examination of regional and global disease processes that contribute to clinical disability in MS.

Original languageEnglish (US)
Pages (from-to)720-728
Number of pages9
JournalNeurology
Volume84
Issue number7
DOIs
StatePublished - Feb 17 2015

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Multiple Sclerosis
Spinal Cord
Nerve Fibers
Visual Acuity
Atrophy
Anisotropy
Brain
Vibration
Hip
Optic Neuritis
Process Assessment (Health Care)
Optical Coherence Tomography
Sclerosis
Pathologic Processes
Optic Nerve
Cross-Sectional Studies

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Relationships between quantitative spinal cord MRI and retinal layers in multiple sclerosis. / Oh, Jiwon; Sotirchos, Elias S.; Saidha, Shiv; Whetstone, Anna; Chen, Min; Newsome, Scott; Zackowski, Kathy; Balcer, Laura J.; Frohman, Elliot; Prince, Jerry Ladd; Diener-West, Marie; Reich, Daniel S.; Calabresi, Peter.

In: Neurology, Vol. 84, No. 7, 17.02.2015, p. 720-728.

Research output: Contribution to journalArticle

Oh, Jiwon ; Sotirchos, Elias S. ; Saidha, Shiv ; Whetstone, Anna ; Chen, Min ; Newsome, Scott ; Zackowski, Kathy ; Balcer, Laura J. ; Frohman, Elliot ; Prince, Jerry Ladd ; Diener-West, Marie ; Reich, Daniel S. ; Calabresi, Peter. / Relationships between quantitative spinal cord MRI and retinal layers in multiple sclerosis. In: Neurology. 2015 ; Vol. 84, No. 7. pp. 720-728.
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T1 - Relationships between quantitative spinal cord MRI and retinal layers in multiple sclerosis

AU - Oh, Jiwon

AU - Sotirchos, Elias S.

AU - Saidha, Shiv

AU - Whetstone, Anna

AU - Chen, Min

AU - Newsome, Scott

AU - Zackowski, Kathy

AU - Balcer, Laura J.

AU - Frohman, Elliot

AU - Prince, Jerry Ladd

AU - Diener-West, Marie

AU - Reich, Daniel S.

AU - Calabresi, Peter

PY - 2015/2/17

Y1 - 2015/2/17

N2 - Objective: To assess relationships between spinal cord MRI (SC-MRI) and retinal measures, and to evaluate whether these measures independently relate to clinical disability inmultiple sclerosis (MS). Methods: One hundred two patients with MS and 11 healthy controls underwent 3-tesla brain and cervical SC-MRI, which included standard T1- and T2-based sequences and diffusion-tensor and magnetization-transfer imaging, and optical coherence tomography with automated segmentation. Clinical assessments included visual acuity (VA), Expanded Disability Status Scale, MS functional composite, vibration sensation threshold, and hip-flexion strength. Regions of interest circumscribing SC cross-sections at C3-4 were used to obtain cross-sectional area (CSA), fractional anisotropy (FA), perpendicular diffusivity (λ⊥), and magnetization transfer ratio. Multivariable regression assessed group differences and SC, retinal, and clinical relationships. Results: In MS, there were correlations between SC-CSA, SC-FA, SC-λ⊥, and peripapillary retinal nerve fiber layer (pRNFL) (p = 0.01, p = 0.002, p = 0.001, respectively) after adjusting for age, sex, prior optic neuritis, and brain atrophy. In multivariable clinical models, when SC-CSA, pRNFL, and brain atrophy were included simultaneously, SC-CSA and pRNFL retained independent relationships with low-contrast VA (p = 0.04, p = 0.002, respectively), high-contrast VA (p = 0.06, p = 0.008), and vibration sensation threshold (p = 0.01, p = 0.05). SC-CSA alone retained independent relationships with Expanded Disability Status Scale (p = 0.001), hip-flexion strength (p = 0.001), and MS functional composite (p = 0.004). Conclusions: In this cross-sectional study of patients with MS, correlations exist between SC-MRI and retinal layers, and both exhibit independent relationships with clinical dysfunction. These findings suggest that the SC and optic nerve reflect ongoing global pathologic processes that supplement measures of whole-brain atrophy, highlighting the importance of combining measures from unique compartments to facilitate a thorough examination of regional and global disease processes that contribute to clinical disability in MS.

AB - Objective: To assess relationships between spinal cord MRI (SC-MRI) and retinal measures, and to evaluate whether these measures independently relate to clinical disability inmultiple sclerosis (MS). Methods: One hundred two patients with MS and 11 healthy controls underwent 3-tesla brain and cervical SC-MRI, which included standard T1- and T2-based sequences and diffusion-tensor and magnetization-transfer imaging, and optical coherence tomography with automated segmentation. Clinical assessments included visual acuity (VA), Expanded Disability Status Scale, MS functional composite, vibration sensation threshold, and hip-flexion strength. Regions of interest circumscribing SC cross-sections at C3-4 were used to obtain cross-sectional area (CSA), fractional anisotropy (FA), perpendicular diffusivity (λ⊥), and magnetization transfer ratio. Multivariable regression assessed group differences and SC, retinal, and clinical relationships. Results: In MS, there were correlations between SC-CSA, SC-FA, SC-λ⊥, and peripapillary retinal nerve fiber layer (pRNFL) (p = 0.01, p = 0.002, p = 0.001, respectively) after adjusting for age, sex, prior optic neuritis, and brain atrophy. In multivariable clinical models, when SC-CSA, pRNFL, and brain atrophy were included simultaneously, SC-CSA and pRNFL retained independent relationships with low-contrast VA (p = 0.04, p = 0.002, respectively), high-contrast VA (p = 0.06, p = 0.008), and vibration sensation threshold (p = 0.01, p = 0.05). SC-CSA alone retained independent relationships with Expanded Disability Status Scale (p = 0.001), hip-flexion strength (p = 0.001), and MS functional composite (p = 0.004). Conclusions: In this cross-sectional study of patients with MS, correlations exist between SC-MRI and retinal layers, and both exhibit independent relationships with clinical dysfunction. These findings suggest that the SC and optic nerve reflect ongoing global pathologic processes that supplement measures of whole-brain atrophy, highlighting the importance of combining measures from unique compartments to facilitate a thorough examination of regional and global disease processes that contribute to clinical disability in MS.

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