Atrophy, focal spinal cord lesions and alterations of diffusion tensor imaging (DTI) parameters in asymptomatic virus carriers and patients suffering from human T-lymphotrophic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP)

• Published in: Journal of neurovirology 2014-12, Vol.20 (6), p.583-590
• Main Authors: Vilchez, Carlos, Gonzalez-Reinoso, Massiel, Cubbison, Caroline, Perez-Then, Eddy, Roa, Pedro, Martínez, Adriano, Foerster, Bernd, Oviedo, Jairo, Stoeter, Peter
• Format: Article
• Language: English
• Subjects: Adult; Asymptomatic Diseases; Atrophy - diagnosis; Atrophy - pathology; Biomedical and Life Sciences; Biomedicine; Carrier State; Case-Control Studies; Diffusion Tensor Imaging; Female; Human T-lymphotropic virus; Human T-lymphotropic virus 1; Human T-lymphotropic virus 1 - physiology; Humans; Immunology; Infectious Diseases; Male; Middle Aged; Neurology; Neurosciences; Paraparesis, Tropical Spastic - diagnosis; Paraparesis, Tropical Spastic - pathology; Severity of Illness Index; Spinal Cord - pathology; Virology
• ISSN: 1355-0284; 1538-2443
• DOI: 10.1007/s13365-014-0282-2

In tropical spastic paraparesis, spinal cord atrophy is a well-known finding in magnetic resonance imaging. But in contrast to histological reports, focal lesions of the spinal cord have only been described in imaging reports in exceptional acute cases. Here, we looked for such focal lesions and for alterations of diffusion tensor imaging parameters of the long fibre tracts in the usual case of a long-standing and slowly progressive disease. We examined 10 symptomatic patients, 11 seropositive, but asymptomatic human T-lymphotrophic virus type 1 carriers and 18 seronegative volunteers as controls. Sagittal and transversal T2-weighted images were visually assessed for atrophy and focal cord lesions. The spinal cord cross-sectional areas and the segmental cord volumes were measured at all levels. High-resolution diffusion tensor imaging was performed in sagittal planes from the bregma down to the cervical spine. For tractography and calculation of fractional anisotropy and mean diffusivity, we used manufacturer-provided software. Two-thirds of patients showed focal lesions affecting the antero-lateral columns and in two cases also the dorsal columns. Compared to carriers and volunteers, patients presented a significant spinal cord atrophy and a reduction of fractional anisotropy ( p