InfraTentorial Atrophy And Disability
In Multiple Sclerosis

Edwards SG, Gong QY, Liu C, Zvartau ME, Jaspan T, Roberts N, Blumhardt LD
Brain 1999 Feb;122 ( Pt 2):291-301
Univ of Nottingham, Division of Clinical Neurology, Nottingham, UK
PMID# 10071057, UI# 99168605

Loss of tissue volume in the Central Nervous System (Atrophy) may provide an index of fixed Neurological Dysfunction in Multiple Sclerosis.

Recent Magnetic Resonance studies have shown a modest relationship between clinical disability rating scores and transverse sectional area of the Cervical Spinal Cord.

    We estimated the volumes of InfraTentorial structures from MRIs in a cross-sectional study of 41 patients:

To explore further the relationship between Atrophy and Disability in Multiple Sclerosis.

We used the Cavalieri method of modern design Stereology with point counting to estimate the volume of BrainStem, Cerebellum and Upper Cervical Spinal Cord from three-dimensional MRIs acquired with an MPRAGE (Magnetization-Prepared Rapid Acquisition Gradient Echo) sequence.

The volume of the Upper (C1-C3) Cervical Spinal Cord was significantly correlated with a composite Spinal Cord score derived from the appropriate Functional Scale scores of the Expanded Disability Status Scale (r = -0.50, P < 0.01).

The Cerebellar (r = 0.49, P < 0.01) and BrainStem (r = 0.34, P < 0.05) volumes correlated with the Scripp's Neurological Disability Rating Scale scores.

The Upper Cervical Cord volumes (r = -0.39, P < 0.01), but not the BrainStem or Cerebellar volumes, were significantly associated with disease duration.

MRI-estimated structural volumes may provide a simple index of Axonal and/or Myelin loss, the presumed pathological substrates of irreversible impairment and Disability in Multiple Sclerosis.

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