Joint assessment of brain and spinal cord motor tract damage in patients with early RRMS: predominant impact of spinal cord lesions on motor function.
Adult
Brain
/ diagnostic imaging
Cervical Cord
/ diagnostic imaging
Cohort Studies
Evoked Potentials, Motor
/ physiology
Female
Humans
Longitudinal Studies
Magnetic Resonance Imaging
/ trends
Male
Motor Skills
/ physiology
Multiple Sclerosis, Relapsing-Remitting
/ diagnostic imaging
Pyramidal Tracts
/ diagnostic imaging
White Matter
/ diagnostic imaging
Electrophysiology
MRI
Multiple sclerosis
Spinal cord
T2 lesions
Journal
Journal of neurology
ISSN: 1432-1459
Titre abrégé: J Neurol
Pays: Germany
ID NLM: 0423161
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
received:
14
02
2019
accepted:
01
06
2019
revised:
30
05
2019
pubmed:
9
6
2019
medline:
29
1
2020
entrez:
9
6
2019
Statut:
ppublish
Résumé
In patients with MS, the effect of structural damage to the corticospinal tract (CST) has been separately evaluated in the brain and spinal cord (SC), even though a cumulative impact is suspected. To evaluate CST damages on both the cortex and cervical SC, and examine their relative associations with motor function, measured both clinically and by electrophysiology. We included 43 patients with early relapsing-remitting MS. Lesions were manually segmented on SC (axial T2*) and brain (3D FLAIR) scans. The CST was automatically segmented using an atlas (SC) or tractography (brain). Lesion volume fractions and diffusion parameters were calculated for SC, brain and CST. Central motor conduction time (CMCT) and triple stimulation technique amplitude ratio were measured for 42 upper limbs, from 22 patients. Mean lesion volume fractions were 5.2% in the SC portion of the CST and 0.9% in the brain portion. We did not find a significant correlation between brain and SC lesion volume fraction (r = 0.06, p = 0.68). The pyramidal EDSS score and CMCT were both significantly correlated with the lesion fraction in the SC CST (r = 0.39, p = 0.01 and r = 0.33, p = 0.03), but not in the brain CST. Our results highlight the major contribution of SC lesions to CST damage and motor function abnormalities.
Sections du résumé
BACKGROUND
BACKGROUND
In patients with MS, the effect of structural damage to the corticospinal tract (CST) has been separately evaluated in the brain and spinal cord (SC), even though a cumulative impact is suspected.
OBJECTIVE
OBJECTIVE
To evaluate CST damages on both the cortex and cervical SC, and examine their relative associations with motor function, measured both clinically and by electrophysiology.
METHODS
METHODS
We included 43 patients with early relapsing-remitting MS. Lesions were manually segmented on SC (axial T2*) and brain (3D FLAIR) scans. The CST was automatically segmented using an atlas (SC) or tractography (brain). Lesion volume fractions and diffusion parameters were calculated for SC, brain and CST. Central motor conduction time (CMCT) and triple stimulation technique amplitude ratio were measured for 42 upper limbs, from 22 patients.
RESULTS
RESULTS
Mean lesion volume fractions were 5.2% in the SC portion of the CST and 0.9% in the brain portion. We did not find a significant correlation between brain and SC lesion volume fraction (r = 0.06, p = 0.68). The pyramidal EDSS score and CMCT were both significantly correlated with the lesion fraction in the SC CST (r = 0.39, p = 0.01 and r = 0.33, p = 0.03), but not in the brain CST.
CONCLUSION
CONCLUSIONS
Our results highlight the major contribution of SC lesions to CST damage and motor function abnormalities.
Identifiants
pubmed: 31175433
doi: 10.1007/s00415-019-09419-5
pii: 10.1007/s00415-019-09419-5
doi:
Types de publication
Clinical Trial
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
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