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Upper cervical cord area in early relapsing‐remitting multiple sclerosis: Cross‐sectional study of factors influencing cord size
Author(s) -
Rashid Waqar,
Davies Gerard R.,
Chard Declan T.,
Griffin Colette M.,
Altmann Dan R.,
Gordon Ros,
Kapoor Raju,
Thompson Alan J.,
Miller David H.
Publication year - 2006
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.20545
Subject(s) - medicine , multiple sclerosis , cord , confounding , atrophy , spinal cord , cohort , nuclear medicine , surgery , psychiatry
Purpose To determine whether the upper cervical cord area (UCCA) is influenced by disease effect in early relapsing‐remitting multiple sclerosis (MS), using statistical modeling to account for potential covariates. Materials and Methods A cohort of 39 patients were studied cross‐sectionally within three years of first symptom onset (median disease duration = 1.6 years) and compared with 26 healthy controls. The UCCA was measured from axial reconstructions of three‐dimensional T 1 ‐weighted scans with automated detection of the edge of the cord. Statistical analysis adjusted for factors such as total intracranial volume (TICV) and gender. Clinical correlations, in particular those thought likely to be related to cord pathology, were also investigated. Results No significant disease effect was noted on UCCA ( P = 0.685), although there was borderline evidence of a lower UCCA in patients with symptoms of bowel or bladder disturbance ( P = 0.043). A strong association was noted between UCCA and TICV (r = 0.558; P ≤ 0.001), and there was a trend for females to have a smaller UCCA ( P = 0.062). The latter finding appeared to reflect a gender‐related difference in TICV ( P ≤ 0.001). Conclusion Atrophy of the upper cervical cord is not readily apparent in most patients early in the course of relapsing‐remitting MS. In evaluations of disease‐related changes in the UCCA in cross‐sectional studies, TICV and gender should be considered as potentially confounding covariates. J. Magn. Reson. Imaging 2006. © 2006 Wiley‐Liss, Inc.