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

被引:56
作者
Oh, Jiwon [1 ,7 ]
Sotirchos, Elias S. [1 ]
Saidha, Shiv [1 ]
Whetstone, Anna [1 ]
Chen, Min [2 ,5 ]
Newsome, Scott D. [1 ]
Zackowski, Kathy [1 ,4 ,8 ]
Balcer, Laura J. [9 ]
Frohman, Elliot [10 ,11 ]
Prince, Jerry [2 ,3 ]
Diener-West, Marie [5 ]
Reich, Daniel S. [1 ,5 ,6 ,12 ]
Calabresi, Peter A. [1 ]
机构
[1] Johns Hopkins Univ, Dept Neurol, Baltimore, MD 21218 USA
[2] Johns Hopkins Univ, Dept Elect & Comp Engn, Baltimore, MD 21218 USA
[3] Johns Hopkins Univ, Dept Comp Sci, Baltimore, MD 21218 USA
[4] Johns Hopkins Univ, Dept Phys Med & Rehabil, Baltimore, MD USA
[5] Johns Hopkins Univ, Dept Biostat, Baltimore, MD 21205 USA
[6] Johns Hopkins Univ, Dept Radiol & Radiol Sci, Baltimore, MD USA
[7] Univ Toronto, St Michaels Hosp, Dept Med, Div Neurol, Toronto, ON M5S 1A1, Canada
[8] Kennedy Krieger Inst, Mot Anal Lab, Baltimore, MD USA
[9] Univ Penn, Sch Med, Dept Neurol, Philadelphia, PA 19104 USA
[10] Univ Texas SW Med Ctr Dallas, Dept Neurol, Dallas, TX 75390 USA
[11] Univ Texas SW Med Ctr Dallas, Dept Ophthalmol, Dallas, TX 75390 USA
[12] NINDS, Translat Neuroradiol Unit, Bethesda, MD 20892 USA
关键词
OPTICAL COHERENCE TOMOGRAPHY; NEUROMYELITIS-OPTICA; AXONAL LOSS; REPRODUCIBILITY; HETEROGENEITY; DEMYELINATION; SEGMENTATION; PATHOGENESIS; PHENOTYPE; PATHOLOGY;
D O I
10.1212/WNL.0000000000001257
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective:To assess relationships between spinal cord MRI (SC-MRI) and retinal measures, and to evaluate whether these measures independently relate to clinical disability in multiple 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 (), 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-(perpendicular to), 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.
引用
收藏
页码:720 / 728
页数:9
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