Imaging spinal cord atrophy in progressive myelopathies: HTLV ‐I‐associated neurological disease (HAM/TSP) and multiple sclerosis (MS)

ObjectivePrevious work measures spinal cord thinning in chronic progressive myelopathies, including human T‐lymphotropic virus 1 (HTLV‐1)‐associated myelopathy/tropical spastic paraparesis (HAM/TSP) and multiple sclerosis (MS). Quantitative measurements of spinal cord atrophy are important in fully characterizing these and other spinal cord diseases. We aimed to investigate patterns of spinal cord atrophy and correlations with clinical markers. MethodsSpinal cord cross‐sectional area was measured in individuals (24 healthy controls [HCs], 17 asymptomatic carriers of HTLV‐1 (AC), 47 HAM/TSP, 74 relapsing‐remitting MS [RRMS], 17 secondary progressive MS [SPMS], and 40 primary progressive MS [PPMS]) from C1 to T10. Clinical disability scores, viral markers, and immunological parameters were obtained for patients and correlated with representative spinal cord cross‐sectional area regions at the C2 to C3, C4 to C5, and T4 to T9 levels. In 2 HAM/TSP patients, spinal cord cross‐sectional area was measured over 3 years. ResultsAll spinal cord regions are thinner in HAM/TSP (56 mm2 [standard deviation, 10], 59 [10], 23 [5]) than in HC (76 [7], 83 [8], 38 [4]) and AC (71 [7], 78 [9], 36 [7]). SPMS (62 [9], 66 [9], 32 [6]) and PPMS (65 [11], 68 [10], 35 [7]) have thinner cervical cords than HC and RRMS (73 [9], 77 [10], 37 [6]). Clinical disability scores (Expanded Disability Status Scale [p = 0.009] and Instituto de Pesquisas de Cananeia [p = 0.03]) and CD8+ T...
Source: Annals of Neurology - Category: Neurology Authors: Tags: Research Article Source Type: research