Tuesday, 3 February 2015

MS is associated with disease in the spinal cord and optic nerve

Oh J, Sotirchos ES, Saidha S, Whetstone A, Chen M, Newsome SD, Zackowski K, Balcer LJ, Frohman E, Prince J, Diener-West M, Reich DS, Calabresi PA. Relationships between quantitative spinal cord MRI and retinal layers in multiple sclerosis.Neurology. 2015 Jan. pii: 10.1212/WNL.0000000000001257. [Epub ahead of print]

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 cervical spinal cord 3-4 were used to obtain cross-sectional area (CSA) and other MR parameters
RESULTS: In MS, there were correlations between SC MRI parameters and 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 models, when SC-CSA, pRNFL, and brain atrophy were included simultaneously, SC-CSA and pRNFL retained independent relationships with low-contrast vision acquity (p = 0.04, p = 0.002, respectively), high-contrast visual acquity (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.
                                      red/orange = T cell lesions

This study says if you have optic nerve damage reflected by nerve damage in the eye (which contains the neurons of the optic nerve axons) then there is a greater chance of having lesions in the spinal cord, but these are not absolutely correlated. So the same as was found with brain lesions and retinal damage,  as was known in EAE long time ago.

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