Patterns of Spinal Cord Atrophy in Neuroinflammatory Diseases (P6.117)

OBJECTIVE: Develop a spinal cord imaging biomarker for neuroinflammatory diseases. BACKGROUND: Multiple sclerosis (MS) and human T-cell lymphotropic virus-1 (HTLV1) associated myelopathy/tropical spastic paraparesis (HAM/TSP) are examples of diseases with progressive myelitis. In HTLV1 infection, there is a correlation between serum proviral load and development of HAM/TSP. Using a fast and robust semiautomatic quantification program analyzing MRI spinal cord images, spinal cord cross sectional area (SCCSA) has been characterized for healthy volunteers (HV), HAM/TSP, asymptomatic HTLV1 carriers (AC) and MS at single time points. DESIGN/METHOD: MRI of the cervical and thoracic cord was obtained in 13 HV, 38 HAM/TSP, 13 AC, 7 progressive MS, and 30 relapsing remitting MS. A subset of HAM/TSP patients had multiple MRIs. HAM/TSP patients also had HTLV1 proviral load in serum and cerebrospinal fluid (CSF) measured. RESULTS: SCCSA in HAM/TSP patients and progressive MS show similar patterns of spinal cord atrophy with both cervical and thoracic cord atrophy. Relapsing remitting MS patients develop cervical cord atrophy with longer duration of disease. Asymptomatic HTLV1 carriers had no difference in SCCSA compared to healthy volunteers. HAM/TSP patients showed a correlation between thoracic cord CSA and CSF proviral load (p<0.05). Longitudinal HAM/TSP spinal cord imaging showed thoracic cord atrophy with short duration of disease that progressed to involve cervical cord with time. CONCLUSION: In addition to extending the spectrum of spinal cord atrophy longitudinally to support the unique patterns of spinal cord atrophy in neuroinflammatory diseases, the study findings suggest the use of SCCSA may be used as a marker for disease progression. Disclosure: Dr. Azodi has nothing to disclose. Dr. Charlip has nothing to disclose. Dr. Liu has nothing to disclose. Dr. Billioux has nothing to disclose. Dr. Vellucci has nothing to disclose. Dr. Ohayon has nothing to disclose. Dr. Nair has nothing to disclose. Dr. Jacobson has nothing to disclose.