Mean upper cervical cord area (MUCCA) measurement in long-standing multiple sclerosis: Relation to brain findings and clinical disability

Marita Daams, Florian Weiler, Martijn D. Steenwijk, Horst K. Hahn, Jeroen J G Geurts, Hugo Vrenken, Ronald A. Van Schijndel, Lisanne J. Balk, Prejaas K. Tewarie, Jan-Mendelt Tillema, Joep Killestein, Bernard M J Uitdehaag, Frederik Barkhof

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Background: The majority of patients with multiple sclerosis (MS) present with spinal cord pathology. Spinal cord atrophy is thought to be a marker of disease severity, but in long-disease duration its relation to brain pathology and clinical disability is largely unknown. Objective: Our aim was to investigate mean upper cervical cord area (MUCCA) in patients with longstanding MS and assess its relation to brain magnetic resonance imaging (MRI) measures and clinical disability. Methods: MUCCA was measured in 196 MS patients and 55 healthy controls using 3DT1-weighted cervical images obtained at 3T MRI. Clinical disability was measured using the Expanded Disability Status Scale (EDSS), Nine-Hole-Peg test (9-HPT), and 25 feet Timed Walk Test (TWT). Stepwise linear regression was performed to assess the association between MUCCA and MRI measures, and between MUCCA and clinical disability. Results: MUCCA was smaller (mean 11.7%) in MS patients compared with healthy controls (72.56±9.82 and 82.24±7.80 mm2 respectively;p<0.001), most prominently in male patients. MUCCA was associated with normalized brain volume, and number of cervical cord lesions. MUCCA was independently associated with EDSS, TWT, and 9-HPT. Conclusion: MUCCA was reduced in MS patients compared with healthy controls. It provides a relevant marker for clinical disability in long-standing disease, independent of other MRI measures.

Original languageEnglish (US)
Pages (from-to)1860-1865
Number of pages6
JournalMultiple Sclerosis
Volume20
Issue number14
DOIs
StatePublished - Dec 16 2014
Externally publishedYes

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Multiple Sclerosis
Brain
Magnetic Resonance Imaging
Spinal Cord
Cervical Cord
Clinical Pathology
Atrophy
Linear Models
Biomarkers
Pathology

Keywords

  • atrophy
  • disability evaluation
  • magnetic resonance imaging
  • Multiple sclerosis
  • spinal cord

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Daams, M., Weiler, F., Steenwijk, M. D., Hahn, H. K., Geurts, J. J. G., Vrenken, H., ... Barkhof, F. (2014). Mean upper cervical cord area (MUCCA) measurement in long-standing multiple sclerosis: Relation to brain findings and clinical disability. Multiple Sclerosis, 20(14), 1860-1865. https://doi.org/10.1177/1352458514533399

Mean upper cervical cord area (MUCCA) measurement in long-standing multiple sclerosis : Relation to brain findings and clinical disability. / Daams, Marita; Weiler, Florian; Steenwijk, Martijn D.; Hahn, Horst K.; Geurts, Jeroen J G; Vrenken, Hugo; Van Schijndel, Ronald A.; Balk, Lisanne J.; Tewarie, Prejaas K.; Tillema, Jan-Mendelt; Killestein, Joep; Uitdehaag, Bernard M J; Barkhof, Frederik.

In: Multiple Sclerosis, Vol. 20, No. 14, 16.12.2014, p. 1860-1865.

Research output: Contribution to journalArticle

Daams, M, Weiler, F, Steenwijk, MD, Hahn, HK, Geurts, JJG, Vrenken, H, Van Schijndel, RA, Balk, LJ, Tewarie, PK, Tillema, J-M, Killestein, J, Uitdehaag, BMJ & Barkhof, F 2014, 'Mean upper cervical cord area (MUCCA) measurement in long-standing multiple sclerosis: Relation to brain findings and clinical disability', Multiple Sclerosis, vol. 20, no. 14, pp. 1860-1865. https://doi.org/10.1177/1352458514533399
Daams, Marita ; Weiler, Florian ; Steenwijk, Martijn D. ; Hahn, Horst K. ; Geurts, Jeroen J G ; Vrenken, Hugo ; Van Schijndel, Ronald A. ; Balk, Lisanne J. ; Tewarie, Prejaas K. ; Tillema, Jan-Mendelt ; Killestein, Joep ; Uitdehaag, Bernard M J ; Barkhof, Frederik. / Mean upper cervical cord area (MUCCA) measurement in long-standing multiple sclerosis : Relation to brain findings and clinical disability. In: Multiple Sclerosis. 2014 ; Vol. 20, No. 14. pp. 1860-1865.
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abstract = "Background: The majority of patients with multiple sclerosis (MS) present with spinal cord pathology. Spinal cord atrophy is thought to be a marker of disease severity, but in long-disease duration its relation to brain pathology and clinical disability is largely unknown. Objective: Our aim was to investigate mean upper cervical cord area (MUCCA) in patients with longstanding MS and assess its relation to brain magnetic resonance imaging (MRI) measures and clinical disability. Methods: MUCCA was measured in 196 MS patients and 55 healthy controls using 3DT1-weighted cervical images obtained at 3T MRI. Clinical disability was measured using the Expanded Disability Status Scale (EDSS), Nine-Hole-Peg test (9-HPT), and 25 feet Timed Walk Test (TWT). Stepwise linear regression was performed to assess the association between MUCCA and MRI measures, and between MUCCA and clinical disability. Results: MUCCA was smaller (mean 11.7{\%}) in MS patients compared with healthy controls (72.56±9.82 and 82.24±7.80 mm2 respectively;p<0.001), most prominently in male patients. MUCCA was associated with normalized brain volume, and number of cervical cord lesions. MUCCA was independently associated with EDSS, TWT, and 9-HPT. Conclusion: MUCCA was reduced in MS patients compared with healthy controls. It provides a relevant marker for clinical disability in long-standing disease, independent of other MRI measures.",
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AU - Hahn, Horst K.

AU - Geurts, Jeroen J G

AU - Vrenken, Hugo

AU - Van Schijndel, Ronald A.

AU - Balk, Lisanne J.

AU - Tewarie, Prejaas K.

AU - Tillema, Jan-Mendelt

AU - Killestein, Joep

AU - Uitdehaag, Bernard M J

AU - Barkhof, Frederik

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N2 - Background: The majority of patients with multiple sclerosis (MS) present with spinal cord pathology. Spinal cord atrophy is thought to be a marker of disease severity, but in long-disease duration its relation to brain pathology and clinical disability is largely unknown. Objective: Our aim was to investigate mean upper cervical cord area (MUCCA) in patients with longstanding MS and assess its relation to brain magnetic resonance imaging (MRI) measures and clinical disability. Methods: MUCCA was measured in 196 MS patients and 55 healthy controls using 3DT1-weighted cervical images obtained at 3T MRI. Clinical disability was measured using the Expanded Disability Status Scale (EDSS), Nine-Hole-Peg test (9-HPT), and 25 feet Timed Walk Test (TWT). Stepwise linear regression was performed to assess the association between MUCCA and MRI measures, and between MUCCA and clinical disability. Results: MUCCA was smaller (mean 11.7%) in MS patients compared with healthy controls (72.56±9.82 and 82.24±7.80 mm2 respectively;p<0.001), most prominently in male patients. MUCCA was associated with normalized brain volume, and number of cervical cord lesions. MUCCA was independently associated with EDSS, TWT, and 9-HPT. Conclusion: MUCCA was reduced in MS patients compared with healthy controls. It provides a relevant marker for clinical disability in long-standing disease, independent of other MRI measures.

AB - Background: The majority of patients with multiple sclerosis (MS) present with spinal cord pathology. Spinal cord atrophy is thought to be a marker of disease severity, but in long-disease duration its relation to brain pathology and clinical disability is largely unknown. Objective: Our aim was to investigate mean upper cervical cord area (MUCCA) in patients with longstanding MS and assess its relation to brain magnetic resonance imaging (MRI) measures and clinical disability. Methods: MUCCA was measured in 196 MS patients and 55 healthy controls using 3DT1-weighted cervical images obtained at 3T MRI. Clinical disability was measured using the Expanded Disability Status Scale (EDSS), Nine-Hole-Peg test (9-HPT), and 25 feet Timed Walk Test (TWT). Stepwise linear regression was performed to assess the association between MUCCA and MRI measures, and between MUCCA and clinical disability. Results: MUCCA was smaller (mean 11.7%) in MS patients compared with healthy controls (72.56±9.82 and 82.24±7.80 mm2 respectively;p<0.001), most prominently in male patients. MUCCA was associated with normalized brain volume, and number of cervical cord lesions. MUCCA was independently associated with EDSS, TWT, and 9-HPT. Conclusion: MUCCA was reduced in MS patients compared with healthy controls. It provides a relevant marker for clinical disability in long-standing disease, independent of other MRI measures.

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