Magnetic resonance imaging of the cervical spinal cord in spinal muscular atrophy
Stam, Marloes; Haakma, Wieke; Kuster, Lidy; Froeling, Martijn; Philippens, Marielle E P; Bos, Clemens; Leemans, Alexander; Otto, Louise A M; van den Berg, Leonard H; Hendrikse, Jeroen; van der Pol, W Ludo
(2019) Neuroimage: Clinical [E], volume 24
(Article)
Abstract
Objective: In this study we investigated the potential value of magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) in characterizing changes in the cervical spinal cord and peripheral nerve roots in vivo in patients with spinal muscular atrophy (SMA). Methods: We developed an MRI protocol with 4 sequences to
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investigate the cervical spinal cord and nerve roots on a 3 Tesla MRI system. We used 2 anatomical MRI sequences to investigate cross-sectional area (CSA) at each spinal segment and the diameter of ventral and dorsal nerve roots, and two diffusion tensor imaging (DTI) techniques to estimate the fractional anisotropy (FA), mean (MD), axial (AD) and radial diffusivity (RD) in 10 SMA patients and 20 healthy controls. Results: There were no significant differences in CSA (p > .1), although an 8.5% reduction of CSA in patients compared to healthy controls was apparent at segment C7. DTI data showed a higher AD in grey matter of patients compared to healthy controls (p = .033). Significantly lower MD, AD and RD values were found in rostral nerve roots (C3-C5) in patients (p < .045). Conclusions: We showed feasibility of an advanced 3 T MRI protocol that allowed differences to be determined between patients and healthy controls, confirming the potential of this technique to assess pathological mechanisms in SMA. After further development and confirmation of findings in a larger sample, these techniques may be used to study disease course of SMA in vivo and evaluate response to survival motor neuron (SMN) augmenting therapy.
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Keywords: DTI, MRI, Nerve roots, SMA, Spinal cord, Spinal muscular atrophy, Clinical Neurology, Neurology, Cognitive Neuroscience, Radiology Nuclear Medicine and imaging, Journal Article
ISSN: 2213-1582
Publisher: Elsevier BV
Note: Funding Information: Leonard H. van den Berg serves on scientific advisory boards for the Prinses Beatrix Spierfonds, Thierry Latran Foundation, Biogen Idec and Cytokinetics; received an educational grant from Baxter International Inc.; serves on the editorial board of Amyotrophic Lateral Sclerosis and the Journal of Neurology, Neurosurgery and Psychiatry; and receives research support from the Prinses Beatrix Fonds.W. Ludo van der Pol serves on scientific advisory boards of Biogen and Avexis and the LMI070 data monitoring committee of Novartis and receives research support from the Prinses Beatrix Spierfonds, Netherlands ALS Foundation and Stichting Spieren voor Spieren.This study was supported by grants from the Prinses Beatrix Spierfonds (WAR08-24, WAR13-07 and WAR14-26) and Stichting Spieren voor Spieren. Prinses Beatrix Spierfonds and Stichting Spieren voor Spieren had no role in study design, data collection, data analysis or interpretation, writing the report or decisions concerning submitting this paper. Publisher Copyright: © 2019
(Peer reviewed)