Expanding the Use of Spinal Cord Atrophy in Multiple Sclerosis: Blake E. Dewey, PhD

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.

Click here for more coverage of CMSC 2022.

REFERENCE
1. Dewey BE, Rjeily NB, Hulett C, et al. Spinal Cord Atrophy As a Marker of Disability Progression: Beyond Trial Data. Presented at: CMSC Annual Meeting; June 1-4, 2022; National Harbor, MD.