Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Sep;33(9):2072-80.
doi: 10.1002/hbm.21346. Epub 2011 Aug 25.

Cervical cord FMRI abnormalities differ between the progressive forms of multiple sclerosis

Paola Valsasina  1 , Maria A Rocca, Martina Absinta, Federica Agosta, Domenico Caputo, Giancarlo Comi, Massimo Filippi
Affiliations

Cervical cord FMRI abnormalities differ between the progressive forms of multiple sclerosis

Paola Valsasina et al. Hum Brain Mapp. 2012 Sep.

Abstract

Objective: Aim of this study was to compare tactile-associated cervical cord fMRI activity between primary progressive (PP) and secondary progressive (SP) MS patients and to investigate whether cord recruitment was associated with structural brain and cord damage.

Experimental design: Cervical cord fMRI during a tactile stimulation of the right hand was acquired from 17 healthy controls, 18 SPMS patients, and 16 PPMS patients. Average fMRI activity and its topographical distribution in cord sectors (left vs. right, posterior vs. anterior) were assessed. Correlations between cord recruitment and structural cord and brain MRI were estimated.

Principal observations: Progressive MS patients showed an increased cord recruitment compared with controls (P = 0.003). Despite a similar structural cord damage, cord activity was increased in SPMS compared to PPMS patients (P = 0.05). Regional analysis showed a non-lateralized pattern of cord recruitment in MS patients. Compared to PPMS, SPMS patients had grey matter (GM) atrophy in several cortical and subcortical regions. In SPMS patients, atrophy of the left postcentral gyrus was correlated with cord activity (r = -0.48, P = 0.04).

Conclusions: Patients with progressive MS had an over-recruitment of the cervical cord, which was more pronounced in SPMS than PPMS, despite similar cord structural damage. The alteration of the complex modulation of spinal cord interneurons possibly due to a loss of supratentorial inhibition secondary to brain injury might contribute to explain the observed functional cord abnormalities.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Statistical parametric mapping (SPM) regions of gray matter (GM) loss superimposed on the customized GM template, contrasting primary progressive (PP) multiple sclerosis (MS) patients, secondary progressive (SP) MS patients, and healthy controls (HC) at a threshold of P < 0.001, uncorrected. A: PPMS patients vs. healthy controls; B: SPMS patients vs. healthy controls; and C: SPMS vs. PPMS patients. Images are in neurological convention.
Figure 2
Figure 2
Illustrative activation maps (color‐coded for t values) of cervical cord on axial proton‐density weighted spin‐echo images from C5 to T1, from a healthy volunteer (A), a patient with primary progressive (PP) multiple sclerosis (MS) (B), and a patient with secondary progressive (SP) MS (C) during a tactile stimulation of the palm of the right hand. R: right, L: left.
Figure 3
Figure 3
Cervical cord average signal change during the tactile stimulation of the palm of the right hand in healthy controls (black line), patients with primary progressive multiple sclerosis (PPMS) (dotted grey line), and patients with secondary progressive multiple sclerosis (SPMS) (continuous grey line). See text for formal statistical analysis.
Figure 4
Figure 4
Scatter plot of the correlation between cord fMRI average signal change and brain grey matter (GM) volume in the left (L) postcetral gyrus in secondary progressive multiple sclerosis (SPMS) patients.
See this image and copyright information in PMC

References

    1. Agosta F, Absinta M, Sormani MP, Ghezzi A, Bertolotto A, Montanari E, Comi G, Filippi M ( 2007a): In vivo assessment of cervical cord damage in MS patients: A longitudinal diffusion tensor MRI study. Brain 130 ( Part 8): 2211–2219. - PubMed
    1. Agosta F, Pagani E, Caputo D, Filippi M ( 2007b): Associations between cervical cord gray matter damage and disability in patients with multiple sclerosis. Arch Neurol 64: 1302–1305. - PubMed
    1. Agosta F, Valsasina P, Rocca MA, Caputo D, Sala S, Judica E, Stroman PW, Filippi M ( 2008): Evidence for enhanced functional activity of cervical cord in relapsing multiple sclerosis. Magn Reson Med 59: 1035–1042. - PubMed
    1. Agosta F, Valsasina P, Absinta M, Sala S, Caputo D, Filippi M ( 2009a): Primary progressive multiple sclerosis: Tactile‐associated functional MR activity in the cervical spinal cord. Radiology 253: 209–215. - PubMed
    1. Agosta F, Valsasina P, Caputo D, Rocca MA, Filippi M ( 2009b): Tactile‐associated fMRI recruitment of the cervical cord in healthy subjects. Hum Brain Mapp 30: 340–345. - PMC - PubMed