Volume 11 Supplement 1
Quantifying spinal cord cross-sectional area in HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP)
© Liu et al; licensee BioMed Central Ltd. 2014
Published: 7 January 2014
The inflammation and subsequent atrophy of the spinal cord are thought to underlie the debilitating symptoms of HAM/TSP. Although spinal cord atrophy can be qualitatively detected on routine clinical MRI, a robust and sensitive method to quantify changes in spinal cord size might capture disease processes. We have developed a novel and fast algorithm to determine the average cross-sectional area in the cervical (c-spine) and thoracic (t-spine) spinal cords by tracing contours perpendicular to the edge in T1-weighted MRI images. The cross-sectional areas in the c- and t-spines were determined in 11 HAM/TSP, 10 multiple sclerosis (MS), and 7 healthy control subjects. Average cross-sectional area in both the t-spine and c-spine were significantly lower in HAM/TSP patients (t-spine: 26.1 ± 5.0 mm2; c-spine: 51.9 ± 6.8 mm2) as compared to MS patients (t-spine: 39.7 ± 8.9 mm2, p=0.0004; c-spine: 68.9 ± 11.6 mm2, p=0.0005) and healthy controls (t-spine: 43.5 ± 5.5 mm2, p<0.0001; c-spine: 84.2 ± 10.9 mm2, p<0.0001). Appreciating the small sample size, t-spine cross-sectional area correlated with blood serum proviral loads (r=-0.62, p=0.04, n=9) and with clinical disability measured by EDSS and IPEC. These results suggest that the pattern of spinal cord tissue damage is specific to the underlying inflammatory disease, a finding that has direct implications for the use of average cross-sectional spinal cord area as a surrogate end point for clinical trials.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.