Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.
Department of Radiology, The University of British Columbia, Vancouver, BC, Canada.
Mult Scler. 2021 Dec;27(14):2191-2198. doi: 10.1177/13524585211001780. Epub 2021 Mar 22.
Myelin water imaging (MWI) was recently optimized to provide quantitative in vivo measurement of spinal cord myelin, which is critically involved in multiple sclerosis (MS) disability.
To assess cervical cord myelin measurements in relapsing-remitting multiple sclerosis (RRMS) and progressive multiple sclerosis (ProgMS) participants and evaluate the correlation between myelin measures and clinical disability.
We used MWI data from 35 RRMS, 30 ProgMS, and 28 healthy control (HC) participants collected at cord level C2/C3 on a 3 T magnetic resonance imaging (MRI) scanner. Myelin heterogeneity index (MHI), a measurement of myelin variability, was calculated for whole cervical cord, global white matter, dorsal column, lateral and ventral funiculi. Correlations were assessed between MHI and Expanded Disability Status Scale (EDSS), 9-Hole Peg Test (9HPT), timed 25-foot walk, and disease duration.
In various regions of the cervical cord, ProgMS MHI was higher compared to HC (between 9.5% and 31%, ⩽ 0.04) and RRMS (between 13% and 26%, ⩽ 0.02), and ProgMS MHI was associated with EDSS ( = 0.42-0.52) and 9HPT ( = 0.45-0.52).
Myelin abnormalities within clinically eloquent areas are related to clinical disability. MWI metrics have a potential role for monitoring subclinical disease progression and adjudicating treatment efficacy for new therapies targeting ProgMS.
髓鞘水成像（MWI）最近得到优化，可提供脊髓髓鞘的定量活体测量，这对多发性硬化症（MS）的残疾至关重要。
评估复发缓解型多发性硬化症（RRMS）和进展型多发性硬化症（ProgMS）患者的颈髓髓鞘测量值，并评估髓鞘测量值与临床残疾之间的相关性。
我们使用了 35 名 RRMS、30 名 ProgMS 和 28 名健康对照（HC）参与者在 3T 磁共振成像（MRI）扫描仪上在颈髓 C2/C3 水平采集的 MWI 数据。髓鞘异质性指数（MHI）是一种测量髓鞘变异性的指标，用于计算整个颈髓、全白质、背柱、侧索和腹索的髓鞘。评估了 MHI 与扩展残疾状态量表（EDSS）、9 孔钉测试（9HPT）、定时 25 英尺步行和疾病持续时间之间的相关性。
在颈髓的不同区域，ProgMS 的 MHI 高于 HC（9.5%至 31%， ⩽ 0.04）和 RRMS（13%至 26%， ⩽ 0.02），并且 ProgMS 的 MHI 与 EDSS（ = 0.42-0.52）和 9HPT（ = 0.45-0.52）相关。
临床功能区的髓鞘异常与临床残疾有关。MWI 指标可能有助于监测亚临床疾病进展，并为针对 ProgMS 的新治疗方法的疗效判断提供依据。
