The postdoctoral researcher at the Johns Hopkins Multiple Sclerosis Center shared his perspective on the use of spinal cord atrophy in clinical practice to measure disease progression in MS and how it might become more accessible. [WATCH TIME: 4 minutes]
WATCH TIME: 4 minutes
“What there tends to be is we get a little bit of a lag before we can finally say that yes, a patient really is progressive. Especially when it comes to drug trials and clinical trials, the definition is very strict. What we’re looking for is [if there are] ways that we can measure a patient’s progression that is either quicker or earlier than these established progression metrics.”
Spinal cord atrophy has been established in the literature for multiple sclerosis (MS) as a reliable marker of disability progression, but as Blake E. Dewy, PhD, postdoctoral researcher, Johns Hopkins Multiple Sclerosis Center, pointed out in a recent conversation with NeurologyLive®, the uptake in its use overall has been slow. This is mainly driven by the lack of routine clinical use of high-quality, high-resolution MRI of the spinal cord.
Although, Dewey noted that T1-weighted brain imaging—a key part of the standard of care imaging in MS—that includes sufficient spinal cord coverage could possibly serve as a substitute for dedicated spinal cord imaging when assessing atrophy. At the 2022 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting, June 1-4, in National Harbor, Maryland, he presented data from an ongoing, prospective study using two different 3T scanners in patients with MS (progressive disease, n = 47; relapsing disease, n = 103), which suggest that the cross-sectional area measurements from T1w brain and T2w spinal cord images were highly correlated (r = 0.93; P <.0001).1
Dewey shared background on the ongoing work and offered his perspective on the use of these images and how it might allow for spinal cord atrophy to be used as a marker in larger populations with longer follow-up than is currently feasible in clinical practice.