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Simultaneous assessment of regional distributions of atrophy across the neuraxis in MS patients

•We present a novel probabilistic brain and neck template to track atrophy.•It allows the simultaneous assessment of brain and spinal cord atrophy.•In MS patients, cervical cord atrophy is linked to impairment.•Our approach improves the utility of MRI to track disease evolution in trials. The abilit...

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Published in:NeuroImage clinical 2022-01, Vol.34, p.102985, Article 102985
Main Authors: Freund, Patrick, Papinutto, Nico, Bischof, Antje, Azzarito, Michela, Kirkish, Gina, Ashburner, John, Thompson, Alan, Hauser, Stephen L., Henry, Roland G.
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container_title NeuroImage clinical
container_volume 34
creator Freund, Patrick
Papinutto, Nico
Bischof, Antje
Azzarito, Michela
Kirkish, Gina
Ashburner, John
Thompson, Alan
Hauser, Stephen L.
Henry, Roland G.
description •We present a novel probabilistic brain and neck template to track atrophy.•It allows the simultaneous assessment of brain and spinal cord atrophy.•In MS patients, cervical cord atrophy is linked to impairment.•Our approach improves the utility of MRI to track disease evolution in trials. The ability to assess brain and cord atrophy simultaneously would improve the efficiency of MRI to track disease evolution. To test a promising tool to simultaneously map the regional distribution of atrophy in multiple sclerosis (MS) patients across the brain and cord. Voxel-based morphometry combined with a statistical parametric mapping probabilistic brain-spinal cord (SPM-BSC) template was applied to standard T1-weighted magnetic resonance imaging (MRI) scans covering the brain and cervical cord from 37 MS patients and 20 healthy controls (HC). We also measured the cord area at C2-C3 with a semi-automatic segmentation method using (i) the same T1-weighted acquisitions used for the new voxel-based analysis and (ii) dedicated spinal cord phase sensitive inversion recovery (PSIR) acquisitions. Cervical cord findings derived from the three approaches were compared to each other and the goodness to fit to clinical scores was assessed by regression analyses. The SPM-BSC approach revealed a severity-dependent pattern of atrophy across the cervical cord and thalamus in MS patients when compared to HCs. The magnitude of cord atrophy was confirmed by the semi-automatic extraction approach at C2-C3 using both standard brain T1-weighted and advanced cord dedicated acquisitions. Associations between atrophy of cord and thalamus with disability and cognition were demonstrated. Atrophy in the brain and cervical cord of MS patients can be identified simultaneously and rapidly at the voxel-level. The SPM-BSC approach yields similar results as available standard processing tools with the added advantage of performing the analysis simultaneously and faster.
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subjects Atrophy - pathology
Cervical Cord - diagnostic imaging
Cervical Cord - pathology
Humans
Magnetic Resonance Imaging - methods
Multiple Sclerosis - diagnostic imaging
Multiple Sclerosis - pathology
Regular
Spinal Cord - pathology
title Simultaneous assessment of regional distributions of atrophy across the neuraxis in MS patients
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