Abstract Details

Title Defining the spinal cord reserve concept in multiple sclerosis - measurement and association with disability of the spinal cord canal area

Topic Multiple Sclerosis

Presentation(s) S26 - MS Imaging (2:00 PM-2:12 PM)

Poster/Presentation
Number 006

Background

The spinal cord is a target of MS related-damage highly relevant towards disability. Differential impact of such damage could be due to the initial amount of tissue, as described for brain reserve, but the concept of spinal cord reserve has not yet been proposed.

Objective

Describe and confirm the concept of spinal cord reserve in Multiple Sclerosis (MS).

Design/Methods

3,172 MRI scans acquired in people with MS from 10 international centres (Multiple Sclerosis Partners Advancing Technology for Health Solutions -MS PATHS- network) were considered for this analysis. Brain scans were acquired on 3.0 T systems with standardized protocols, including sagittal 3D T1-weighted scans covering down to cervical 5 (c5) level. Spinal cord and canal areas (SCA and SCaA) were obtained with the Spinal Cord Toolbox. Spinal cord parenchymal fraction (SCPF) was calculated as SCA/SCaA. Patient-derived disability scores (including the Patient Determined Disease Steps -PDDS-) and demographical data were obtained. The MS PATHS Image Evaluation (MSPie) tool was used to estimate T2 lesion volume. Forty-two healthy controls (HC) were also included. SCA, SCaA and SCPF was compared between people with MS and HC with age and sex-adjusted linear regression models. Scaled linear models were built to investigate the associations between SCaA and PDDS, adjusted for SCPF, T2 lesion volume, sex and age.

Results

1,747 patients were analysed (mean age: 46.35 years; 73,2% female). SCA and SCPF were lower in patients compared to HC (SCA: 60.35 vs 65.02 mm2, p<0.001; SCPF: 0.28 vs 0.31, p<0.001), but no differences in SCaA were observed (212.61 vs 213.24 mm2, p=0.125). In patients, scaled linear models showed that a larger SCaA was significantly associated with lower scores on PDDS (beta coefficient: -0.12, p=0.012).

Conclusions

A larger spinal cord reserve, represented by a larger area of the spinal canal, seems protective against disability in MS, a concept akin to brain reserve.

Authors/Disclosures
Jaume Sastre-Garriga PRESENTER	The institution of Jaume Sastre-Garriga has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. The institution of Jaume Sastre-Garriga has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Celgene. The institution of Jaume Sastre-Garriga has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. The institution of Jaume Sastre-Garriga has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Sanofi. The institution of Jaume Sastre-Garriga has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Orchid Pharma. The institution of Jaume Sastre-Garriga has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for BIOGEN. Jaume Sastre-Garriga has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Multiple Sclerosis Journal. Jaume Sastre-Garriga has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Revista de Neurologia. The institution of Jaume Sastre-Garriga has received research support from Fondo de Investigación Sanitaria.
Alex Rovira	Alex Rovira has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofy. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers. Alex Rovira has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer. Alex Rovira has stock in Tensor Medical.
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Mar Tintore	The institution of Mar Tintore has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. The institution of Mar Tintore has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck. The institution of Mar Tintore has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. The institution of Mar Tintore has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche . The institution of Mar Tintore has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi Genzyme . The institution of Mar Tintore has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Teva. The institution of Mar Tintore has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Viela bio. The institution of Mar Tintore has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Janssen. Mar Tintore has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Mar Tintore has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Mar Tintore has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Mar Tintore has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche . The institution of Mar Tintore has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. The institution of Mar Tintore has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Parexel and UCB Biopharma. Mar Tintore has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Multiple Sclerosis Journal: Experimental, Translational and Clinical. The institution of Mar Tintore has received research support from Fundació La Marató de TV3. The institution of Mar Tintore has received research support from Instituto de Salud Carlos III. The institution of Mar Tintore has received research support from Instituto de Salud Carlos III.
Xavier Montalban, MD, PhD, FAAN (Vall Hebron University Hospital-Multiple Sclerosis Centre of Catalonia)	The institution of Dr. Montalban has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. The institution of Dr. Montalban has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck/ EMD Serono. The institution of Dr. Montalban has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. The institution of Dr. Montalban has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Teva. The institution of Dr. Montalban has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Hoffmann-La Roche. The institution of Dr. Montalban has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Actelion/ Janssen. The institution of Dr. Montalban has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for BMS/ Celgene. The institution of Dr. Montalban has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi/ Genzyme. Dr. Montalban has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Actelion/ Janssen. Dr. Montalban has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Montalban has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BMS/ Celgene. Dr. Montalban has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck/ EMD Serono. Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hoffmann-La Roche. Dr. Montalban has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi-Genzyme. The institution of Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunic Therapeutics. The institution of Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Viatris/ Mylan. The institution of Dr. Montalban has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sandoz. The institution of Dr. Montalban has received research support from Biogen. The institution of Dr. Montalban has received research support from Hoffmann-La Roche. The institution of Dr. Montalban has received research support from Sanofi/ Genzyme. The institution of Dr. Montalban has received research support from Merck/ EMD Serono. The institution of Dr. Montalban has received research support from Novartis. The institution of Dr. Montalban has received research support from Teva Pharmaceuticals. The institution of Dr. Montalban has received research support from Actelion/ Janssen. The institution of Dr. Montalban has received research support from BMS/ Celgene.
	No disclosure on file