Antje Bischof, MD: Accelerated Cord Atrophy Precedes Conversion to SPMS in RRMS


The Postdoctoral Scholar at the University of California San Francisco spoke about a longitudinal study that evaluated the utility of spinal cord atrophy measured from brain scans as a surrogate marker for impending conversion to secondary progressive MS.

“What we found was that patients who went on to convert to secondary progressive disease during our study period had much higher rates of spinal cord atrophy thanthose patients who remained stable during the entire observation period until today which is two decades of disease since disease onset.”

At the fourth annual Americans Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2019 held in Dallas, Texas, Antje Bischof, MD, University of California, San Francisco, presented research that found that upper cervical cord atrophy obtained from routine brain MRI is a strong indicator of impending conversion from relapsing-remitting multiple sclerosis (MS) to secondary progressive MS (SPMS)

Bischof and colleagues conducted a longitudinal study that evaluated spinal cord atrophy measured in patients with MS through MRI over 12 years. Fifty-four patients with relapsing-remitting MS who converted to SPMS during the observation period were matched based on certain demographic and clinical criteria to 54 subjects with relapsing-remitting MS who remained relapsing-remitting MS during the observation period. Additionally, 54 age- and sex-matched healthy controls were evaluated at baseline.

Brain volumetric and spinal cord area at C1 level were analyzed from brain MRI in order to evaluate their potential to differentiate between the 2 matched groups prior to the conversion period. Those who developed SPMS demonstrated an accelerated rate (-2.15% per year) before conversion to secondary progressive compared to those with relapsing-remitting MS matches who did not convert to SPMS (-.74% per year). The data suggest that the difference exists at least 4 years before conversion to SPMS.

Bischof concluded that the cervical atrophy rate at C1 level can be used as a prognostic marker to study MS and measure the long-term impact of treatment in trials.

To dive deeper into this research and the results from the study, NeurologyLive sat down with Bischof at the meeting.

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