Characterizing 1-year development of cervical cord atrophy across different MS phenotypes: A voxel-wise, multicentre analysis

Paola Valsasina, Claudio Gobbi, Chiara Zecca, Alex Rovira, Jaume Sastre-Garriga, Hugh Kearney, Marios Yiannakas, Lucy Matthews, Jacqueline Palace, Antonio Gallo, Alvino Bisecco, Achim Gass, Philipp Eisele, Massimo Filippi, Maria A. Rocca*, Frederik Barkhof, Olga Ciccarelli, Nicola de Stefano, Christian Enzinger, Claudio GasperiniLudwig Kappos, Hugo Vrenken, Tarek Yousry

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: Spatio-temporal evolution of cord atrophy in multiple sclerosis (MS) has not been investigated yet. Objective: To evaluate voxel-wise distribution and 1-year changes of cervical cord atrophy in a multicentre MS cohort. Methods: Baseline and 1-year 3D T1-weighted cervical cord scans and clinical evaluations of 54 healthy controls (HC) and 113 MS patients (14 clinically isolated syndromes (CIS), 77 relapsing-remitting (RR), 22 progressive (P)) were used to investigate voxel-wise cord volume loss in patients versus HC, 1-year volume changes and clinical correlations (SPM12). Results: MS patients exhibited baseline cord atrophy versus HC at anterior and posterior/lateral C1/C2 and C4–C6 (p < 0.05, corrected). While CIS patients showed baseline volume increase at C4 versus HC (p < 0.001, uncorrected), RRMS exhibited posterior/lateral C1/C2 atrophy versus CIS, and PMS showed widespread cord atrophy versus RRMS (p < 0.05, corrected). At 1 year, 13 patients had clinically worsened. Cord atrophy progressed in MS, driven by RRMS, at posterior/lateral C2 and C3–C6 (p < 0.05, corrected). CIS patients showed no volume changes, while PMS showed circumscribed atrophy progression. Baseline cord atrophy at posterior/lateral C1/C2 and C3–C6 correlated with concomitant and 1-year disability (r = −0.40/–0.62, p < 0.05, corrected). Conclusions: Voxel-wise analysis characterized spinal cord neurodegeneration over 1 year across MS phenotypes and helped to explain baseline and 1-year disability.
Original languageEnglish
Pages (from-to)885-899
JournalMultiple Sclerosis Journal
Issue number6
Publication statusPublished - 1 May 2022

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