Spinal Cord Atrophy in Multiple Sclerosis: A Systematic Review and Meta‐Analysis
ABSTRACT BACKGROUND AND PURPOSE Spinal cord atrophy (SCA) is an important emerging outcome measure in multiple sclerosis (MS); however, there is limited consensus on the magnitude and rate of atrophy. The objective of this study was to synthesize the available data on measures of SCA in MS. METHODS...
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| Veröffentlicht in: | Journal of neuroimaging 2018-11, Vol.28 (6), p.556-586 |
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| creator | Casserly, Courtney Seyman, Estelle E. Alcaide‐Leon, Paula Guenette, Melanie Lyons, Carrie Sankar, Stephanie Svendrovski, Anton Baral, Stefan Oh, Jiwon |
| description | ABSTRACT
BACKGROUND AND PURPOSE
Spinal cord atrophy (SCA) is an important emerging outcome measure in multiple sclerosis (MS); however, there is limited consensus on the magnitude and rate of atrophy. The objective of this study was to synthesize the available data on measures of SCA in MS.
METHODS
Using published guidelines, relevant literature databases were searched between 1977 and 2017 for case‐control or cohort studies reporting a quantitative measure of SCA in MS patients. Random‐effects models pooled cross‐sectional measures and longitudinal rates of SCA in MS and healthy controls (HCs). Student's t‐test assessed differences between pooled measures in patient subgroups. Heterogeneity was assessed using DerSimonian and Laird's Q‐test and the I 2‐index.
RESULTS
A total of 1,465 studies were retrieved including 94 that met inclusion and exclusion criteria. Pooled estimates of mean cervical spinal cord (SC) cross‐sectional area (CSA) in all MS patients, relapsing‐remitting MS (RRMS), all progressive MS, secondary progressive MS (SPMS), primary‐progressive MS (PPMS), and HC were: 73.07 mm2 (95% CI [71.52‐74.62]), 78.88 mm2 (95% CI [76.92‐80.85]), 69.72 mm2 (95% CI [67.96‐71.48]), 68.55 mm2 (95% CI [65.43‐71.66]), 70.98 mm2 (95% CI [68.78‐73.19]), and 80.87 mm2 (95% C I [78.70‐83.04]), respectively. Pooled SC‐CSA was greater in HC versus MS (P < .001) and RRMS versus progressive MS (P < .001). SCA showed moderate correlations with global disability in cross‐sectional studies (r‐value with disability score range [−.75 to −.22]). In longitudinal studies, the pooled annual rate of SCA was 1.78%/year (95%CI [1.28‐2.27]).
CONCLUSIONS
The SC is atrophied in MS. The magnitude of SCA is greater in progressive versus relapsing forms and correlates with clinical disability. The pooled estimate of annual rate of SCA is greater than reported rates of brain atrophy in MS. These results demonstrate that SCA is highly relevant as an imaging outcome in MS clinical trials. |
| doi_str_mv | 10.1111/jon.12553 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2087994372</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2127565776</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4193-c89707f1b1cd7d87bdac7cab0ac79e58a29df200a2818bc2b277ea1bca677a6c3</originalsourceid><addsrcrecordid>eNp10L1OwzAUBWALgWgpDLwAssQCQ1rbieOELar4VaFSC3PkOI5w5SbBTqiy8Qg8I0-CIYUBCS_Xw-ej6wPAMUZj7M5kVZVjTCj1d8AQU0q8kIbxrrsjij1ComAADqxdIURwQPx9MPARRgQhfwgWy1qVXMNpZXKYNKaqnzuoSnjf6kbVWsKl0NJUVtkLmMBlZxu55o0ScCFfldxAXubwXjb84-09cTmdg4dgr-DayqPtHIGnq8vH6Y03m1_fTpOZJwIc-56IYoZYgTMscpZHLMu5YIJnyI1Y0oiTOC_ckpxEOMoEyQhjkuNM8JAxHgp_BM763NpUL620TbpWVkiteSmr1qYERSyOA58RR0__0FXVGrevU5gwGlLGQqfOeyXch62RRVobteamSzFKv4p2r8r0u2hnT7aJbbaW-a_8adaBSQ82Ssvu_6T0bv7QR34CzNuHiQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2127565776</pqid></control><display><type>article</type><title>Spinal Cord Atrophy in Multiple Sclerosis: A Systematic Review and Meta‐Analysis</title><source>Wiley Online Library - AutoHoldings Journals</source><creator>Casserly, Courtney ; Seyman, Estelle E. ; Alcaide‐Leon, Paula ; Guenette, Melanie ; Lyons, Carrie ; Sankar, Stephanie ; Svendrovski, Anton ; Baral, Stefan ; Oh, Jiwon</creator><creatorcontrib>Casserly, Courtney ; Seyman, Estelle E. ; Alcaide‐Leon, Paula ; Guenette, Melanie ; Lyons, Carrie ; Sankar, Stephanie ; Svendrovski, Anton ; Baral, Stefan ; Oh, Jiwon</creatorcontrib><description>ABSTRACT
BACKGROUND AND PURPOSE
Spinal cord atrophy (SCA) is an important emerging outcome measure in multiple sclerosis (MS); however, there is limited consensus on the magnitude and rate of atrophy. The objective of this study was to synthesize the available data on measures of SCA in MS.
METHODS
Using published guidelines, relevant literature databases were searched between 1977 and 2017 for case‐control or cohort studies reporting a quantitative measure of SCA in MS patients. Random‐effects models pooled cross‐sectional measures and longitudinal rates of SCA in MS and healthy controls (HCs). Student's t‐test assessed differences between pooled measures in patient subgroups. Heterogeneity was assessed using DerSimonian and Laird's Q‐test and the I 2‐index.
RESULTS
A total of 1,465 studies were retrieved including 94 that met inclusion and exclusion criteria. Pooled estimates of mean cervical spinal cord (SC) cross‐sectional area (CSA) in all MS patients, relapsing‐remitting MS (RRMS), all progressive MS, secondary progressive MS (SPMS), primary‐progressive MS (PPMS), and HC were: 73.07 mm2 (95% CI [71.52‐74.62]), 78.88 mm2 (95% CI [76.92‐80.85]), 69.72 mm2 (95% CI [67.96‐71.48]), 68.55 mm2 (95% CI [65.43‐71.66]), 70.98 mm2 (95% CI [68.78‐73.19]), and 80.87 mm2 (95% C I [78.70‐83.04]), respectively. Pooled SC‐CSA was greater in HC versus MS (P < .001) and RRMS versus progressive MS (P < .001). SCA showed moderate correlations with global disability in cross‐sectional studies (r‐value with disability score range [−.75 to −.22]). In longitudinal studies, the pooled annual rate of SCA was 1.78%/year (95%CI [1.28‐2.27]).
CONCLUSIONS
The SC is atrophied in MS. The magnitude of SCA is greater in progressive versus relapsing forms and correlates with clinical disability. The pooled estimate of annual rate of SCA is greater than reported rates of brain atrophy in MS. These results demonstrate that SCA is highly relevant as an imaging outcome in MS clinical trials.</description><identifier>ISSN: 1051-2284</identifier><identifier>EISSN: 1552-6569</identifier><identifier>DOI: 10.1111/jon.12553</identifier><identifier>PMID: 30102003</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Atrophy ; Brain ; Clinical trials ; Correlation analysis ; Heterogeneity ; Longitudinal studies ; magnetic resonance imaging (MRI) ; Medical research ; Meta-analysis ; Multiple sclerosis ; Neuroimaging ; Patients ; Spinal cord ; Spinal cord atrophy ; Subgroups ; systematic review</subject><ispartof>Journal of neuroimaging, 2018-11, Vol.28 (6), p.556-586</ispartof><rights>2018 by the American Society of Neuroimaging</rights><rights>2018 by the American Society of Neuroimaging.</rights><rights>2018 American Society of Neuroimaging</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4193-c89707f1b1cd7d87bdac7cab0ac79e58a29df200a2818bc2b277ea1bca677a6c3</citedby><cites>FETCH-LOGICAL-c4193-c89707f1b1cd7d87bdac7cab0ac79e58a29df200a2818bc2b277ea1bca677a6c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjon.12553$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjon.12553$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30102003$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Casserly, Courtney</creatorcontrib><creatorcontrib>Seyman, Estelle E.</creatorcontrib><creatorcontrib>Alcaide‐Leon, Paula</creatorcontrib><creatorcontrib>Guenette, Melanie</creatorcontrib><creatorcontrib>Lyons, Carrie</creatorcontrib><creatorcontrib>Sankar, Stephanie</creatorcontrib><creatorcontrib>Svendrovski, Anton</creatorcontrib><creatorcontrib>Baral, Stefan</creatorcontrib><creatorcontrib>Oh, Jiwon</creatorcontrib><title>Spinal Cord Atrophy in Multiple Sclerosis: A Systematic Review and Meta‐Analysis</title><title>Journal of neuroimaging</title><addtitle>J Neuroimaging</addtitle><description>ABSTRACT
BACKGROUND AND PURPOSE
Spinal cord atrophy (SCA) is an important emerging outcome measure in multiple sclerosis (MS); however, there is limited consensus on the magnitude and rate of atrophy. The objective of this study was to synthesize the available data on measures of SCA in MS.
METHODS
Using published guidelines, relevant literature databases were searched between 1977 and 2017 for case‐control or cohort studies reporting a quantitative measure of SCA in MS patients. Random‐effects models pooled cross‐sectional measures and longitudinal rates of SCA in MS and healthy controls (HCs). Student's t‐test assessed differences between pooled measures in patient subgroups. Heterogeneity was assessed using DerSimonian and Laird's Q‐test and the I 2‐index.
RESULTS
A total of 1,465 studies were retrieved including 94 that met inclusion and exclusion criteria. Pooled estimates of mean cervical spinal cord (SC) cross‐sectional area (CSA) in all MS patients, relapsing‐remitting MS (RRMS), all progressive MS, secondary progressive MS (SPMS), primary‐progressive MS (PPMS), and HC were: 73.07 mm2 (95% CI [71.52‐74.62]), 78.88 mm2 (95% CI [76.92‐80.85]), 69.72 mm2 (95% CI [67.96‐71.48]), 68.55 mm2 (95% CI [65.43‐71.66]), 70.98 mm2 (95% CI [68.78‐73.19]), and 80.87 mm2 (95% C I [78.70‐83.04]), respectively. Pooled SC‐CSA was greater in HC versus MS (P < .001) and RRMS versus progressive MS (P < .001). SCA showed moderate correlations with global disability in cross‐sectional studies (r‐value with disability score range [−.75 to −.22]). In longitudinal studies, the pooled annual rate of SCA was 1.78%/year (95%CI [1.28‐2.27]).
CONCLUSIONS
The SC is atrophied in MS. The magnitude of SCA is greater in progressive versus relapsing forms and correlates with clinical disability. The pooled estimate of annual rate of SCA is greater than reported rates of brain atrophy in MS. These results demonstrate that SCA is highly relevant as an imaging outcome in MS clinical trials.</description><subject>Atrophy</subject><subject>Brain</subject><subject>Clinical trials</subject><subject>Correlation analysis</subject><subject>Heterogeneity</subject><subject>Longitudinal studies</subject><subject>magnetic resonance imaging (MRI)</subject><subject>Medical research</subject><subject>Meta-analysis</subject><subject>Multiple sclerosis</subject><subject>Neuroimaging</subject><subject>Patients</subject><subject>Spinal cord</subject><subject>Spinal cord atrophy</subject><subject>Subgroups</subject><subject>systematic review</subject><issn>1051-2284</issn><issn>1552-6569</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp10L1OwzAUBWALgWgpDLwAssQCQ1rbieOELar4VaFSC3PkOI5w5SbBTqiy8Qg8I0-CIYUBCS_Xw-ej6wPAMUZj7M5kVZVjTCj1d8AQU0q8kIbxrrsjij1ComAADqxdIURwQPx9MPARRgQhfwgWy1qVXMNpZXKYNKaqnzuoSnjf6kbVWsKl0NJUVtkLmMBlZxu55o0ScCFfldxAXubwXjb84-09cTmdg4dgr-DayqPtHIGnq8vH6Y03m1_fTpOZJwIc-56IYoZYgTMscpZHLMu5YIJnyI1Y0oiTOC_ckpxEOMoEyQhjkuNM8JAxHgp_BM763NpUL620TbpWVkiteSmr1qYERSyOA58RR0__0FXVGrevU5gwGlLGQqfOeyXch62RRVobteamSzFKv4p2r8r0u2hnT7aJbbaW-a_8adaBSQ82Ssvu_6T0bv7QR34CzNuHiQ</recordid><startdate>201811</startdate><enddate>201811</enddate><creator>Casserly, Courtney</creator><creator>Seyman, Estelle E.</creator><creator>Alcaide‐Leon, Paula</creator><creator>Guenette, Melanie</creator><creator>Lyons, Carrie</creator><creator>Sankar, Stephanie</creator><creator>Svendrovski, Anton</creator><creator>Baral, Stefan</creator><creator>Oh, Jiwon</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7QP</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201811</creationdate><title>Spinal Cord Atrophy in Multiple Sclerosis: A Systematic Review and Meta‐Analysis</title><author>Casserly, Courtney ; Seyman, Estelle E. ; Alcaide‐Leon, Paula ; Guenette, Melanie ; Lyons, Carrie ; Sankar, Stephanie ; Svendrovski, Anton ; Baral, Stefan ; Oh, Jiwon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4193-c89707f1b1cd7d87bdac7cab0ac79e58a29df200a2818bc2b277ea1bca677a6c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Atrophy</topic><topic>Brain</topic><topic>Clinical trials</topic><topic>Correlation analysis</topic><topic>Heterogeneity</topic><topic>Longitudinal studies</topic><topic>magnetic resonance imaging (MRI)</topic><topic>Medical research</topic><topic>Meta-analysis</topic><topic>Multiple sclerosis</topic><topic>Neuroimaging</topic><topic>Patients</topic><topic>Spinal cord</topic><topic>Spinal cord atrophy</topic><topic>Subgroups</topic><topic>systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Casserly, Courtney</creatorcontrib><creatorcontrib>Seyman, Estelle E.</creatorcontrib><creatorcontrib>Alcaide‐Leon, Paula</creatorcontrib><creatorcontrib>Guenette, Melanie</creatorcontrib><creatorcontrib>Lyons, Carrie</creatorcontrib><creatorcontrib>Sankar, Stephanie</creatorcontrib><creatorcontrib>Svendrovski, Anton</creatorcontrib><creatorcontrib>Baral, Stefan</creatorcontrib><creatorcontrib>Oh, Jiwon</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neuroimaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Casserly, Courtney</au><au>Seyman, Estelle E.</au><au>Alcaide‐Leon, Paula</au><au>Guenette, Melanie</au><au>Lyons, Carrie</au><au>Sankar, Stephanie</au><au>Svendrovski, Anton</au><au>Baral, Stefan</au><au>Oh, Jiwon</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Spinal Cord Atrophy in Multiple Sclerosis: A Systematic Review and Meta‐Analysis</atitle><jtitle>Journal of neuroimaging</jtitle><addtitle>J Neuroimaging</addtitle><date>2018-11</date><risdate>2018</risdate><volume>28</volume><issue>6</issue><spage>556</spage><epage>586</epage><pages>556-586</pages><issn>1051-2284</issn><eissn>1552-6569</eissn><abstract>ABSTRACT
BACKGROUND AND PURPOSE
Spinal cord atrophy (SCA) is an important emerging outcome measure in multiple sclerosis (MS); however, there is limited consensus on the magnitude and rate of atrophy. The objective of this study was to synthesize the available data on measures of SCA in MS.
METHODS
Using published guidelines, relevant literature databases were searched between 1977 and 2017 for case‐control or cohort studies reporting a quantitative measure of SCA in MS patients. Random‐effects models pooled cross‐sectional measures and longitudinal rates of SCA in MS and healthy controls (HCs). Student's t‐test assessed differences between pooled measures in patient subgroups. Heterogeneity was assessed using DerSimonian and Laird's Q‐test and the I 2‐index.
RESULTS
A total of 1,465 studies were retrieved including 94 that met inclusion and exclusion criteria. Pooled estimates of mean cervical spinal cord (SC) cross‐sectional area (CSA) in all MS patients, relapsing‐remitting MS (RRMS), all progressive MS, secondary progressive MS (SPMS), primary‐progressive MS (PPMS), and HC were: 73.07 mm2 (95% CI [71.52‐74.62]), 78.88 mm2 (95% CI [76.92‐80.85]), 69.72 mm2 (95% CI [67.96‐71.48]), 68.55 mm2 (95% CI [65.43‐71.66]), 70.98 mm2 (95% CI [68.78‐73.19]), and 80.87 mm2 (95% C I [78.70‐83.04]), respectively. Pooled SC‐CSA was greater in HC versus MS (P < .001) and RRMS versus progressive MS (P < .001). SCA showed moderate correlations with global disability in cross‐sectional studies (r‐value with disability score range [−.75 to −.22]). In longitudinal studies, the pooled annual rate of SCA was 1.78%/year (95%CI [1.28‐2.27]).
CONCLUSIONS
The SC is atrophied in MS. The magnitude of SCA is greater in progressive versus relapsing forms and correlates with clinical disability. The pooled estimate of annual rate of SCA is greater than reported rates of brain atrophy in MS. These results demonstrate that SCA is highly relevant as an imaging outcome in MS clinical trials.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>30102003</pmid><doi>10.1111/jon.12553</doi><tpages>31</tpages></addata></record> |
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| subjects | Atrophy Brain Clinical trials Correlation analysis Heterogeneity Longitudinal studies magnetic resonance imaging (MRI) Medical research Meta-analysis Multiple sclerosis Neuroimaging Patients Spinal cord Spinal cord atrophy Subgroups systematic review |
| title | Spinal Cord Atrophy in Multiple Sclerosis: A Systematic Review and Meta‐Analysis |
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