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<meta name="DC.Title" content="Medulla Oblongata Volume: A Biomarker of Spinal Cord Damage and Disability in Multiple Sclerosis" />
<meta name="DC.Identifier" content="10.3174/ajnr.A1162" />
<meta name="DC.Date" content="2008-09-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="Copyright © American Society of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: While brain MR imaging is routinely performed, the MR imaging assessment of spinal cord pathology in multiple sclerosis (MS) is less frequent in clinical practice. The purpose of this study was to determine whether measurements of medulla oblongata volume (MOV) on routine brain MR imaging could serve as a biomarker of spinal cord damage and disability in MS.

MATERIALS AND METHODS: We identified 45 patients with MS with both head and cervical spinal cord MR imaging and 29 age-matched and sex-matched healthy control subjects with head MR imaging. Disability was assessed by the expanded disability status scale (EDSS) and ambulation index (AI). MOV and upper cervical cord volume (UCCV) were manually segmented; semiautomated segmentation was used for brain parenchymal fraction (BPF). These measures were compared between groups, and linear regression models were built to predict disability.

RESULTS: In the patients, MOV correlated significantly with UCCV ( r = 0.67), BPF ( r = 0.45), disease duration ( r = −0.64), age ( r = −0.47), EDSS score ( r = −0.49) and AI ( r = −0.52). Volume loss of the medulla oblongata was −0.008 cm3/year of age in patients with MS, but no significant linear relationship with age was found for healthy control subjects. The patients had a smaller MOV (mean ± SD, 1.02 ± 0.17 cm3) than healthy control subjects (1.15 ± 0.15 cm3), though BPF was unable to distinguish between these 2 groups. MOV was smaller in patients with progressive MS (secondary- progressive MS, 0.88 ± 0.19 cm3 and primary-progressive MS, 0.95 ± 0.30 cm3) than in patients with relapsing-remitting MS (1.08 ± 0.15 cm3). A model including both MOV and BPF better predicted AI than BPF alone ( P = .04). Good reproducibility in MOV measurements was demonstrated for intrarater (intraclass correlation coefficient, 0.97), interrater (0.79), and scan rescan data (0.81).

CONCLUSION: MOV is associated with disability in MS and can serve as a biomarker of spinal cord damage." />
<meta name="DC.Contributor" content="Z. Liptak" />
<meta name="DC.Contributor" content="A.M. Berger" />
<meta name="DC.Contributor" content="M.P. Sampat" />
<meta name="DC.Contributor" content="A. Charil" />
<meta name="DC.Contributor" content="O. Felsovalyi" />
<meta name="DC.Contributor" content="B.C. Healy" />
<meta name="DC.Contributor" content="P. Hildenbrand" />
<meta name="DC.Contributor" content="S.J. Khoury" />
<meta name="DC.Contributor" content="H.L. Weiner" />
<meta name="DC.Contributor" content="R. Bakshi" />
<meta name="DC.Contributor" content="C.R.G. Guttmann" />
<meta name="article:published_time" content="2008-09-01" />
<meta name="article:section" content="SPINE" />
<meta name="citation_title" content="Medulla Oblongata Volume: A Biomarker of Spinal Cord Damage and Disability in Multiple Sclerosis" />
<meta name="citation_abstract" lang="en" content="&lt;p&gt;&lt;b&gt;BACKGROUND AND PURPOSE:&lt;/b&gt; While brain MR imaging is routinely performed, the MR imaging assessment of spinal cord pathology in multiple sclerosis (MS) is less frequent in clinical practice. The purpose of this study was to determine whether measurements of medulla oblongata volume (MOV) on routine brain MR imaging could serve as a biomarker of spinal cord damage and disability in MS.&lt;/p&gt;&lt;p&gt;&lt;b&gt;MATERIALS AND METHODS:&lt;/b&gt; We identified 45 patients with MS with both head and cervical spinal cord MR imaging and 29 age-matched and sex-matched healthy control subjects with head MR imaging. Disability was assessed by the expanded disability status scale (EDSS) and ambulation index (AI). MOV and upper cervical cord volume (UCCV) were manually segmented; semiautomated segmentation was used for brain parenchymal fraction (BPF). These measures were compared between groups, and linear regression models were built to predict disability.&lt;/p&gt;&lt;p&gt;&lt;b&gt;RESULTS:&lt;/b&gt; In the patients, MOV correlated significantly with UCCV (&lt;i&gt;r&lt;/i&gt; = 0.67), BPF (&lt;i&gt;r&lt;/i&gt; = 0.45), disease duration (&lt;i&gt;r&lt;/i&gt; = −0.64), age (&lt;i&gt;r&lt;/i&gt; = −0.47), EDSS score (&lt;i&gt;r&lt;/i&gt; = −0.49) and AI (&lt;i&gt;r&lt;/i&gt; = −0.52). Volume loss of the medulla oblongata was −0.008 cm&lt;sup&gt;3&lt;/sup&gt;/year of age in patients with MS, but no significant linear relationship with age was found for healthy control subjects. The patients had a smaller MOV (mean ± SD, 1.02 ± 0.17 cm&lt;sup&gt;3&lt;/sup&gt;) than healthy control subjects (1.15 ± 0.15 cm&lt;sup&gt;3&lt;/sup&gt;), though BPF was unable to distinguish between these 2 groups. MOV was smaller in patients with progressive MS (secondary- progressive MS, 0.88 ± 0.19 cm&lt;sup&gt;3&lt;/sup&gt; and primary-progressive MS, 0.95 ± 0.30 cm&lt;sup&gt;3&lt;/sup&gt;) than in patients with relapsing-remitting MS (1.08 ± 0.15 cm&lt;sup&gt;3&lt;/sup&gt;). A model including both MOV and BPF better predicted AI than BPF alone (&lt;i&gt;P&lt;/i&gt; = .04). Good reproducibility in MOV measurements was demonstrated for intrarater (intraclass correlation coefficient, 0.97), interrater (0.79), and scan rescan data (0.81).&lt;/p&gt;&lt;p&gt;&lt;b&gt;CONCLUSION:&lt;/b&gt; MOV is associated with disability in MS and can serve as a biomarker of spinal cord damage.&lt;/p&gt;" />
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<meta name="citation_publication_date" content="2008/09/01" />
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<meta name="citation_issn" content="0195-6108" />
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<meta name="citation_author" content="Z. Liptak" />
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<meta name="twitter:title" content="Medulla Oblongata Volume: A Biomarker of Spinal Cord Damage and Disability in Multiple Sclerosis" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: While brain MR imaging is routinely performed, the MR imaging assessment of spinal cord pathology in multiple sclerosis (MS) is less frequent in clinical practice. The purpose of this study was to determine whether measurements of medulla oblongata volume (MOV) on routine brain MR imaging could serve as a biomarker of spinal cord damage and disability in MS.

MATERIALS AND METHODS: We identified 45 patients with MS with both head and cervical spinal cord MR imaging and 29 age-matched and sex-matched healthy control subjects with head MR imaging. Disability was assessed by the expanded disability status scale (EDSS) and ambulation index (AI). MOV and upper cervical cord volume (UCCV) were manually segmented; semiautomated segmentation was used for brain parenchymal fraction (BPF). These measures were compared between groups, and linear regression models were built to predict disability.

RESULTS: In the patients, MOV correlated significantly with UCCV ( r = 0.67), BPF ( r = 0.45), disease duration ( r = −0.64), age ( r = −0.47), EDSS score ( r = −0.49) and AI ( r = −0.52). Volume loss of the medulla oblongata was −0.008 cm3/year of age in patients with MS, but no significant linear relationship with age was found for healthy control subjects. The patients had a smaller MOV (mean ± SD, 1.02 ± 0.17 cm3) than healthy control subjects (1.15 ± 0.15 cm3), though BPF was unable to distinguish between these 2 groups. MOV was smaller in patients with progressive MS (secondary- progressive MS, 0.88 ± 0.19 cm3 and primary-progressive MS, 0.95 ± 0.30 cm3) than in patients with relapsing-remitting MS (1.08 ± 0.15 cm3). A model including both MOV and BPF better predicted AI than BPF alone ( P = .04). Good reproducibility in MOV measurements was demonstrated for intrarater (intraclass correlation coefficient, 0.97), interrater (0.79), and scan rescan data (0.81).

CONCLUSION: MOV is associated with disability in MS and can serve as a biomarker of spinal cord damage." />
<meta name="og-title" property="og:title" content="Medulla Oblongata Volume: A Biomarker of Spinal Cord Damage and Disability in Multiple Sclerosis" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/29/8/1465" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: While brain MR imaging is routinely performed, the MR imaging assessment of spinal cord pathology in multiple sclerosis (MS) is less frequent in clinical practice. The purpose of this study was to determine whether measurements of medulla oblongata volume (MOV) on routine brain MR imaging could serve as a biomarker of spinal cord damage and disability in MS.

MATERIALS AND METHODS: We identified 45 patients with MS with both head and cervical spinal cord MR imaging and 29 age-matched and sex-matched healthy control subjects with head MR imaging. Disability was assessed by the expanded disability status scale (EDSS) and ambulation index (AI). MOV and upper cervical cord volume (UCCV) were manually segmented; semiautomated segmentation was used for brain parenchymal fraction (BPF). These measures were compared between groups, and linear regression models were built to predict disability.

RESULTS: In the patients, MOV correlated significantly with UCCV ( r = 0.67), BPF ( r = 0.45), disease duration ( r = −0.64), age ( r = −0.47), EDSS score ( r = −0.49) and AI ( r = −0.52). Volume loss of the medulla oblongata was −0.008 cm3/year of age in patients with MS, but no significant linear relationship with age was found for healthy control subjects. The patients had a smaller MOV (mean ± SD, 1.02 ± 0.17 cm3) than healthy control subjects (1.15 ± 0.15 cm3), though BPF was unable to distinguish between these 2 groups. MOV was smaller in patients with progressive MS (secondary- progressive MS, 0.88 ± 0.19 cm3 and primary-progressive MS, 0.95 ± 0.30 cm3) than in patients with relapsing-remitting MS (1.08 ± 0.15 cm3). A model including both MOV and BPF better predicted AI than BPF alone ( P = .04). Good reproducibility in MOV measurements was demonstrated for intrarater (intraclass correlation coefficient, 0.97), interrater (0.79), and scan rescan data (0.81).

CONCLUSION: MOV is associated with disability in MS and can serve as a biomarker of spinal cord damage." />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node8399--5" data-node-nid="8399" id="top-node-8399--6323055875" data-pisa="ajnr;29/8/1465" data-pisa-master="ajnr;ajnr.A1162" data-apath="/ajnr/29/8/1465.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
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      <h1 class="highwire-cite-title" id="page-title">Medulla Oblongata Volume: A Biomarker of Spinal Cord Damage and Disability in Multiple Sclerosis</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Z. Liptak</span>, <span class="highwire-citation-author" data-delta="1">A.M. Berger</span>, <span class="highwire-citation-author" data-delta="2">M.P. Sampat</span>, <span class="highwire-citation-author" data-delta="3">A. Charil</span>, <span class="highwire-citation-author" data-delta="4">O. Felsovalyi</span>, <span class="highwire-citation-author" data-delta="5">B.C. Healy</span>, <span class="highwire-citation-author" data-delta="6">P. Hildenbrand</span>, <span class="highwire-citation-author" data-delta="7">S.J. Khoury</span>, <span class="highwire-citation-author" data-delta="8">H.L. Weiner</span>, <span class="highwire-citation-author" data-delta="9">R. Bakshi</span> and <span class="highwire-citation-author" data-delta="10">C.R.G. Guttmann</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">September 2008,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">29 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1465-1470; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A1162 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-8399--6323055875" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Z. Liptak </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Z.%2BLiptak%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Liptak%20Z&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AZ.%2BLiptak%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">A.M. 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Charil </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BCharil%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Charil%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.%2BCharil%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">O. 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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 29</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 8 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">September 2008 </div></div>
      
      
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">Z.</span> <span class="nlm-surname">Liptak</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">A.M.</span> <span class="nlm-surname">Berger</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">M.P.</span> <span class="nlm-surname">Sampat</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Charil</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">O.</span> <span class="nlm-surname">Felsovalyi</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">B.C.</span> <span class="nlm-surname">Healy</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">P.</span> <span class="nlm-surname">Hildenbrand</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">S.J.</span> <span class="nlm-surname">Khoury</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">H.L.</span> <span class="nlm-surname">Weiner</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Bakshi</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">C.R.G.</span> <span class="nlm-surname">Guttmann</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Sep 2008, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">29 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1465-1470; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A1162 </span></div>
  
  
  
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