Biomedical subjects

Paul S Morgan

Publications and source records attributed to Paul S Morgan.

At least 19 recordsLinked to original sources

PubMed2007

Structural white matter abnormalities in patients with idiopathic dystonia.

We investigated whether structural white matter abnormalities, in the form of disruption of axonal coherence and integrity as measured with diffusion tensor imaging (DTI), constitute an underlying pathological mechanism of idiopathic dystonia (ID), independent of genotype status. We studied seven subjects with ID: all had cervical dystonia as their main symptom (one patient also had spasmodic dysphonia and two patients had concurrent generalized dystonia, both DYT1-negative). We compared DTI MR images of patients with 10 controls, evaluating differences in mean diffusivity (MD) and fractional anisotropy (FA). ID was associated with increased FA values in the thalamus and adjacent white matter, and in the white matter underlying the middle frontal gyrus. ID was also associated with increase in MD in adjacent white matter to the pallidum and putamen bilaterally, left caudate, and in subcortical hemispheric regions, including the postcentral gyrus. Abnormal FA and MD in patients with ID indicate that abnormal axonal coherence and integrity contribute to the pathophysiology of dystonia. These findings suggest that ID is not only a functional disorder, but also associated with structural brain changes. Impaired connectivity and disrupted flow of information may contribute to the impairment of motor planning and regulation in dystonia.

Adult↗

PubMed2006

Role of the human supplementary eye field in the control of saccadic eye movements.

The precise function of the supplementary eye field (SEF) is poorly understood. Although electrophysiological and functional imaging studies are important for demonstrating when SEF neurones are active, lesion studies are critical to establish the functions for which the SEF is essential. Here we report a series of investigations performed on an extremely rare individual with a highly focal lesion of the medial frontal cortex. High-resolution structural imaging demonstrated that his lesion was confined to the region of the left paracentral sulcus, the anatomical locus of the SEF. Behavioural testing revealed that the patient was significantly impaired when required to switch between anti- and pro-saccades, when there were conflicting rules governing stimulus-response mappings for saccades. Similarly, the results of an arbitrary stimulus-response associative learning task demonstrated that he was impaired when required to select the appropriate saccade from conflicting eye movement responses, but not for limb movements on an analogous manual task. When making memory-guided saccadic sequences, the patient demonstrated hypometria, like patients with Parkinson's disease, but had no significant difficulties in reproducing the order of saccades correctly on a task that emphasized accuracy with a wide temporal segregation between responses. These findings are consistent with the hypothesis that the SEF plays a key role in implementing control when there is conflict between several, ongoing competing saccadic responses, but not when eye movements need to be made accurately in sequence.

Association Learning↗

PubMed2006

Parietal updating of limb posture: an event-related fMRI study.

The posterior parietal cortex (PPC) is thought to integrate different kinds of sensory information (e.g., visual, auditory, somatosensory) to produce multiple representations of space that are each associated with different types or combinations of action; such as saccadic eye movements and reaching or grasping movements of the upper limb. Lesion studies in monkeys and in humans have shown that reaching movements to visually defined and to posturally defined targets can be dissociated from one another; indicating that different regions of the parietal cortex may code the same movement in either extrinsic (visual) or intrinsic (postural) coordinates. These studies also suggest that regions within the posterior parietal cortex play an important role in maintaining an accurate and up-to-date representation of the current postural state of the body (the body schema). We used event-related functional magnetic resonance imaging (fMRI) to investigate those brain areas involved in maintaining and updating postural (i.e., non-visual) representations of the upper limb that participate in the accurate control of reaching movements. We show that a change in the posture of the upper-limb is associated with a significant increase in BOLD activation in only one brain region--the superior parietal cortex, particularly the medial aspect (precuneus). We note that this finding is consistent with the suggestion, based upon human neurological investigations and monkey electrophysiology, that this region of the PPC may participate in the dynamic representation of the body schema, and is the most likely location for damage leading to errors in visually guided reaching to non-foveated target locations. We also note that this brain area corresponds to a region of PPC recently identified as the human homologue of the Parietal Reach Region (PRR) observed in the monkey brain that has been thought to represent reaching movements in eye-centred coordinates.

Adult↗

PubMed2006

Measuring the hemodynamic response in chronic hypoperfusion.

Although structural brain scans help assess brain injury in stroke, they cannot identify regions that are functionally disabled due to disrupted perfusion. Perfusion and functional MRI have the potential for determining the functional consequences of stroke. Here we examine the effectiveness of functional MRI to measure brain function in a single patient (LB) with chronic hypoperfusion. When LB made sustained hand movements we observed a sustained decrease in the fMRI signal, while normal individuals exhibit a sustained increase in signal while conducting this task. This work has clear implications for understanding stroke using functional MRI.

Brain Injuries↗

PubMed2006

T2-weighted and T2 relaxometry images in patients with medial temporal lobe epilepsy.

PURPOSE: Quantification of increased T2-weighted MRI signal that is associated with hippocampal sclerosis (HS) can be performed through (1) mean of hippocampal signal in single-echo T2 MRI and (2) hippocampal T2 relaxometry. It is not clear whether these two techniques are equivalent. In this study, we compare the hippocampal signal, detected by single-echo T2 quantification and by T2 relaxometry, in patients with medial temporal lobe epilepsy (MTLE). METHODS: We studied magnetic resonance images from 50 MTLE patients and 15 healthy subjects. We compared the quantification of a T2 signal from single echo images to T2 relaxometry, both obtained from a manually traced region of interest (ROI) in coronal slices involving the whole hippocampus. Repeated measures ANOVA was used to evaluate the differences in the distribution of the Z-scores from single-echo T2 quantification and T2 relaxometry within subjects. RESULTS: We observed a significant difference between the measurements obtained from single-echo T2 quantification and T2 relaxometry (P < .001). Measurements from head, body, and tail of the hippocampus were different (P=.04), with a significant interaction between anatomic location and type of measurement used (P= .008). Post hoc paired comparisons revealed that T2 relaxometry yielded greater Z-scores for the body (P= .002) and tail (P < .0001). CONCLUSIONS: For each subject with MTLE, T2 relaxometry was able to detect a higher signal in the body and tail of the hippocampus compared to single-echo T2. This is a possible indicator that T2 relaxometry is more sensitive in detecting T2 abnormalities within the body and tail of the hippocampus in patients with MTLE.

Analysis of Variance↗

PubMed2005

'Importance sampling' in MS: use of diffusion tensor tractography to quantify pathology related to specific impairment.

Specific neurological impairments in multiple sclerosis (MS) are dependent on the pathology in clinically eloquent areas of the central nervous system. We aimed to use diffusion tensor fiber tracking to identify the pyramidal tracts and corpus callosum in MS patients, measure the apparent diffusivity within the tracts, and evaluate whether this would correlate with relevant disability scores. Dual-echo and diffusion tensor magnetic resonance imaging (DT-MRI) brain scans were obtained from 29 patients with relapsing remitting MS, and 13 age and gender matched normal controls. Voxels from pyramidal tracts and corpus callosum were automatically identified using a tractography based algorithm. Mean apparent diffusion coefficient (ADC(av)) was measured for these tracts. Scores of Expanded Disability Status Scale (EDSS) and Paced Auditory Serial Addition Test (PASAT) were obtained. The median EDSS score was 2.5 (inter-quartile range 2-3.25). The ADC(av) in the pyramidal tracts (p=0.02) and corpus callosum (p=0.0004) in patients was significantly higher than in controls. Pyramidal tracts ADC(av) was correlated with pyramidal FSS (r=0.5, p=0.008). Corpus callosum ADC(av) was correlated with PASAT (r=-0.58, p=0.001). Global T2 lesion volume did not correlate with the EDSS, but correlated with ADC(av) of the pyramidal tracts (r=0.6, p=0.0007) and corpus callosum (r=0.8, p<0.0001). T2 lesion volume within the pyramidal tracts and corpus callosum correlated with ADC(av) in the pyramidal tracts (r=0.6, p=0.0009) and corpus callosum (r=0.65, p=0.0002) respectively, but not with pyramidal FSS or PASAT score. DT-MRI quantifies pathology in specific white matter tracts and may increase the specificity of MRI in monitoring progression of motor and cognitive deficits in MS.

Acoustic Stimulation↗

PubMed2005

Measurement of cervical spinal cord cross-sectional area by MRI using edge detection and partial volume correction.

PURPOSE: To detail a procedure to accurately measure upper cervical cord cross-sectional area (CSA), using MRI, by correcting for partial volume averaging (PVA), and to assess the usefulness of the procedure for measuring cervical cord atrophy rates in longitudinal studies. MATERIALS AND METHODS: Analysis of errors associated with measuring CSA in the presence of PVA is given. A numerical phantom image is produced, including simulated acquisition noise, to assess accuracy of the method in idealized conditions, and to verify the results of the error analysis. A phantom, consisting of 11 rods of known CSA, was scanned 10 times and measurement accuracy assessed. A total of 10 normal subjects were scanned twice to assess the reproducibility under experimental conditions. RESULTS: The measurement error for the numerical phantom increased with increased simulated acquisition noise, as predicted by the analysis. Measurement of the plastic phantom revealed a systematic overestimate in CSA due to limited scanner accuracy of 3.15%. The scan-rescan error for the CSA of the cervical spine in the 10 normal subjects was 0.55%. CONCLUSION: Correcting for PVA allows accurate measurement of the upper cervical cord CSA and accurate measurement of a standard phantom to guard against scanner drift in longitudinal studies of cord CSA.

Algorithms↗

PubMed2005

Brain damage and cortical compensation in foreign accent syndrome.

Foreign Accent Syndrome (FAS) is a well-known neurological deficit whose underlying cause has remained obscure despite almost a century of study. Combining structural and functional imaging, our studies suggest that FAS represents a compensatory response to impaired motor regulation of speech. We describe a patient who acquired FAS as a result of an ischemic stroke in the left basal ganglia. In addition to this case being exceptionally clean, we were able to confirm a specific lesion location as well as provide strong evidence that impaired motor speech regulation resulted in compensation by other areas of the cortical motor speech network.

Brain Injuries↗

PubMed2005

Spinal cord imaging in multiple sclerosis.

Multiple sclerosis (MS) is a chronic neurological condition characterized pathologically by axonal loss, demyelination, inflammation, and gliosis. Magnetic resonance imaging (MRI) has had a major impact on diagnosing MS, understanding the condition, and monitoring the effects of treatments. Recently, spinal cord MRI has received increased attention. Advanced techniques have been used to image the spinal cord, particularly the cervical cord, and measure quantitative parameters such as T1 relaxation time, magnetization transfer ratio, and diffusivity. These metrics show central nervous system abnormalities in MS patients and various correlations with disability and might reflect specific pathological processes. Image analysis techniques have also been developed and combined with high-resolution MRI to measure the cord cross-sectional area (CSA), a metric that relates to cord atrophy. The cord CSA is reduced in MS patients compared to normal controls and correlates with disability. Furthermore, changes in CSA are detectable and correlate with changes in disability. Despite the technical difficulties of performing spinal cord MRI, imaging studies, particularly of the cervical cord, are becoming more common. Significant focus has been placed on measuring cord atrophy, and reproducible techniques have been developed to measure the cervical cord CSA. Spinal cord MRI may provide information about disease progression that is not readily available from brain MRI scans and could be useful in diagnosing MS in some cases, as well as for monitoring the effects of treatments.

Atrophy↗

PubMed2004

Correction of spatial distortion in EPI due to inhomogeneous static magnetic fields using the reversed gradient method.

PURPOSE: To derive and implement a method for correcting spatial distortion caused by in vivo inhomogeneous static magnetic fields in echo-planar imaging (EPI). MATERIALS AND METHODS: The reversed gradient method, which was initially devised to correct distortion in images generated by spin-warp MRI, was adapted to correct distortion in EP images. This method provides point-by-point correction of distortion throughout the image. EP images, acquired with a 3 T MRI system, of a phantom and a volunteer's head were used to test the correction method. RESULTS: Good correction was observed in all cases. Spatial distortion in the uncorrected images ranged up to 4 pixels (12 mm) and was corrected successfully. CONCLUSION: The correction was improved by the application of a nonlinear interpolation scheme. The correction requires that two EP images be acquired at each slice position. This increases the acquisition time, but an improved signal-to-noise ratio (SNR) is seen in the corrected image. The local SNR gain decreases with increasing distortion. In many EPI acquisition schemes, multiple images are averaged at each slice position to increase the SNR; in such cases the reversed gradient correction method can be applied with no increase in acquisition duration.

Brain↗

PubMed2004

Iliac compression syndrome and recanalization of femoropopliteal and iliac venous thrombosis: a prospective study with magnetic resonance venography.

OBJECTIVES: Poor iliac vein recanalization has been associated with compression of the left common iliac vein by the right common iliac artery (RCIA/LCIV compression); however, this finding has been difficult to confirm. In a baseline study, RCIA/LCIV compression was detected with magnetic resonance imaging in patients with deep venous thrombosis. We compared recanalization of left femoropopliteal and iliac thrombosis with and without RCIA/LCIV compression. METHODS: This was a prospective blinded study carried out in a 1355-bed university hospital. Thirty-one patients were recruited from consecutive cohorts of patients with iliofemoral and femoropopliteal DVT who underwent direct thrombus magnetic resonance imaging, venous enhanced peak arterial magnetic resonance venography, and magnetic resonance arteriography as part of the baseline study relating RCIA/LCIV compression to extent of thrombosis. Magnetic resonance venography was performed 6 weeks, 6 months, and 1 year after diagnosis of deep venous thrombosis. Femoropopliteal and iliac venous segments that were occluded at diagnosis were classified as occluded, partially occluded, or patent on follow-up scans. RESULTS: At 6-week follow-up, recanalization of all segments was incomplete. At both 6-month and 1-year follow-up, recanalization of left iliac segments associated with RCIA/LCIV compression was poorer compared with recanalization of left iliac segments not associated with compression (6 of 6 occluded vs 1 of 6 occluded and 1 of 6 partially occluded at 6 months, P =.015; 6 of 6 occluded vs 5 of 5 patent at 1 year, P = .002). This was due to complete failure of recanalization of left common iliac veins associated with RCIA/LCIV compression in 6 of 6 cases. All other iliac and femoropopliteal segments including left external iliac veins associated with RCIA/LCIV compression had high rates of recanalization at both 6 months and 1 year. CONCLUSION: RCIA/LCIV compression is associated with persistent occlusion of the left common iliac vein. The recanalization rate for all other femoropopliteal and iliac segments was high.

Constriction, Pathologic↗

PubMed2004

Re-evaluation of iliac compression syndrome using magnetic resonance imaging in patients with acute deep venous thromboses.

BACKGROUND: The majority of proximal deep venous thromboses (DVTs) are thought to have propagated as a contiguous column from the calf veins. However, several authors have proposed that ileofemoral DVT commonly originates in the left common iliac vein (LCIV) at a site of compression by the overlying right common iliac artery (RCIA/LCIV compression). This mechanism could explain both the left-sided predominance of ileofemoral DVT and the finding that ileofemoral DVT frequently occurs either in the absence of calf vein thrombosis (isolated ileofemoral DVT) or is not contiguous with calf vein thrombosis (noncontiguous ileofemoral DVT). This mechanism remains unconfirmed. OBJECTIVES: The purpose of this study was to detect RCIA/LCIV compression using multimodal magnetic resonance imaging in thrombosed and patent iliac veins, to determine whether RCIA/LCIV compression occurs more frequently in cases of left ileofemoral DVT than other types of DVT, and to determine if RCIA/LCIV compression is specifically associated with left isolated and noncontiguous ileofemoral DVT. PATIENTS AND METHODS: This prospective study conducted at the 1355-bed University Hospital included 18 patients with ileofemoral DVT, 23 with femoropopliteal DVT, 15 with isolated calf DVT recruited consecutively, and 28 control patients in whom DVT had been excluded. Interventions included magnetic resonance direct thrombus imaging (MRDTI), venous enhanced peak arterial magnetic resonance venography (VESPA) and magnetic resonance arteriography (MRA) within 48 hours of routine conventional venography (CV). RCIA/LCIV compression of patent LCIVs was assessed using VESPA and MRA; RCIA/LCIV compression of thrombosed LCIVs was assessed using MRDTI and MRA. The extent of calf and popliteal thrombosis was detected using CV; the extent of femoral and iliac thrombosis was detected using VESPA and MRDTI. RESULTS: RCIA/LCIV compression was more commonly detected in cases of left ileofemoral DVT (9/16 cases) than in cases of left femoropopliteal DVT (1/11 cases; P = .018), right femoropopliteal DVT (2/12 cases; P = .054), left isolated calf DVT (1/9 cases; P = .037), right isolated calf DVT (0/6 cases; P = .046) and control patients (4/28 cases; P = .006). RCIA/LCIV compression was more commonly detected in cases of left isolated ileofemoral DVT (6/6 cases; P = .005), and cases of left noncontiguous ileofemoral DVT (2/2 cases; P = .067) than in cases in which thrombosis was contiguous from the calf to the iliac veins (1/8 cases). CONCLUSION: RCIA/LCIV compression was strongly associated with left ileofemoral DVT and was specifically associated with cases that involve independent ileofemoral thrombosis.

Adult↗

PubMed2003

Prevalence of complicated carotid atheroma as detected by magnetic resonance direct thrombus imaging in patients with suspected carotid artery stenosis and previous acute cerebral ischemia.

BACKGROUND: It is recognized that complicated plaque largely accounts for the morbidity and mortality from atherosclerosis. Ideally, investigation of symptomatic and asymptomatic patients would identify atheromatous plaques independently of stenosis. We have previously shown that a magnetic resonance direct thrombus imaging (MRDTI) technique demonstrates complicated atheroma as high signal within the carotid arterial wall. We used this technique to examine the prevalence of complicated carotid plaque in vivo in the ipsilateral arteries of recently symptomatic patients with suspected carotid artery stenosis and to compare this with their contralateral arteries and with those of healthy age- and sex-matched controls. METHODS AND RESULTS: The carotid arteries of 120 patients with suspected severe carotid artery stenosis and previous acute cerebral ischemia were imaged using MRDTI, as were 28 control arteries. High signal was not seen in any control artery. However, there was a 60% prevalence of high signal, suggestive of complicated plaque in the patients' ipsilateral arteries. The prevalence of high signal was significantly greater in the patients' ipsilateral vessels compared with the contralateral, asymptomatic side (60% versus 36%, chi2 P<0.001), particularly for vessels of only moderate stenosis. CONCLUSIONS: MRDTI high signal suggestive of complicated plaque is prevalent in the ipsilateral carotid arteries of patients with carotid stenosis and recent cerebral ischemic events. MRDTI has a potential role in identifying "at risk" plaque, studying atherogenesis and the effects of plaque-modifying strategies.

Brain Ischemia↗

PubMed2003

Characterization of complicated carotid plaque with magnetic resonance direct thrombus imaging in patients with cerebral ischemia.

BACKGROUND: Thromboembolic disease secondary to complicated carotid atherosclerotic plaque is a major cause of cerebral ischemia. Clinical management relies on the detection of significant (>70%) carotid stenosis. A large proportion of patients suffer irreversible cerebral ischemia as a result of lesser degrees of stenosis. Diagnostic techniques that can identify nonstenotic high-risk plaque would therefore be beneficial. High-risk plaque is defined histologically if it contains hemorrhage/thrombus. Magnetic resonance direct thrombus imaging (MRDTI) is capable of detecting methemoglobin within intraplaque hemorrhage. We assessed this as a marker of complicated plaque and compared its accuracy with histological examination of surgical endarterectomy specimens. METHODS AND RESULTS: Sixty-three patients underwent successful MRDTI and endarterectomy with histological examination. Of these, 44 were histologically defined as complicated (type VI plaque). MRDTI demonstrated 3 false-positive and 7 false-negative results, giving a sensitivity and specificity of 84%, negative predictive value of 70%, and positive predictive value of 93%. The interobserver (kappa=0.75) and intraobserver (kappa=0.9) agreement for reading MRDTI scans was good. CONCLUSIONS: MRDTI of the carotid vessels in patients with cerebral ischemia is an accurate means of identifying histologically confirmed complicated plaque. The high contrast generated by short T1 species within the plaque allows for ease of interpretation, making this technique highly applicable in the research and clinical setting for the investigation of carotid atherosclerotic disease.

Aged↗

PubMed2003

Deep venous thrombosis: diagnosis by using venous enhanced subtracted peak arterial MR venography versus conventional venography.

PURPOSE: To assess diagnostic accuracy and interobserver variability at venous enhanced subtracted peak arterial (VESPA) magnetic resonance (MR) venography compared with those at conventional venography for the diagnosis of femoral and iliac deep venous thrombosis (DVT). MATERIALS AND METHODS: A single anteroposterior maximum intensity projection (MIP) venogram of the femoral and iliac veins was constructed by using VESPA MR venography in 55 symptomatic patients suspected of having lower limb DVT. All patients also underwent conventional venography, results of which were used as the standard of reference. VESPA MR venograms were interpreted by two independent reviewers (reviewers A and B) who were unaware of other results. Sensitivity and specificity of VESPA MR venography for the diagnosis of thrombus in the femoral and iliac veins were calculated. Interobserver variability was calculated for these observations by using weighted kappa with equally spaced weights for positive, nondiagnostic, and negative studies. Nondiagnostic studies were reinterpreted separately by reviewer A on the basis of source data. RESULTS: Sensitivity of VESPA MR venography for the femoral veins (20 of 20) and iliac veins (seven of seven) was 100% for both reviewers. Specificity was 100% (39 of 39 for reviewer A, 40 of 40 for reviewer B) for the iliac veins and 97% (31 of 32) for the femoral veins for both reviewers. Segments in which the VESPA MR venograms were nondiagnostic were excluded from this analysis. Interobserver variability as calculated by using weighted kappa for positive, negative, and nondiagnostic studies was 0.85 for femoral veins and 0.97 for iliac veins. Interpretation of the source data led to correct diagnosis in six of six cases in which the VESPA MR venograms were nondiagnostic. CONCLUSION: VESPA MR venography yielded MIP venograms that were highly accurate for the diagnosis of DVT in femoral and iliac veins. Interpretation of the studies was also highly reproducible.

Adult↗

PubMed2003

MR tagging of human lungs using hyperpolarized 3He gas.

PURPOSE: To evaluate the use of spin-tagging in conjunction with hyperpolarized gas imaging for monitoring lung ventilation and gas diffusion. METHODS AND MATERIALS: Images were taken at 0.15 T using single shot RARE, with hyperpolarized (3)He gas prepared by the metastability exchange technique. Sinusoidal modulation of the longitudinal magnetization (tag) was produced by two 90-degree rf pulses separated by a gradient pulse. The diffusion of (3)He gas in the lungs was measured by monitoring the decay of the tags. This study was conducted on a 25-year-old, male, healthy volunteer. RESULTS: Clear tags in hyperpolarized (3)He gas both in vivo and in vitro were generated. The relative movement of the lung compared to a static, partial breath-hold was measured following inspiration or expiration. The diffusion coefficient of (3)He in the lungs was found to be 0.02 +/- 0.005 cm(2)seconds(-1). CONCLUSION: The spin-tagging of hyperpolarized (3)He in the lungs is possible, and allows regional lung movements to be measured following inspiration and expiration. It also allows quantification of the diffusion of the (3)He gas.

Adult↗

PubMed2003

Separating arterial and venous components from 3D dynamic contrast-enhanced MRI studies using factor analysis.

Dynamic contrast-enhanced MRI has been used extensively for angiography but in order to generate separate arterial and venous images some form of postprocessing is required. This typically involves the subtraction of one image in a dynamic sequence from another in order to suppress unwanted signal; however, this also has the effect of decreasing the signal-to-noise ratio (SNR) of the image. In this study, factor analysis, a technique related to eigenimage filtering, is used to separate arterial and venous components from dynamic contrast-enhanced images of the legs acquired with a temporal resolution of 30 sec. The SNR of the venous and arterial images extracted from a series of 20 patients using conventional single subtraction, a double subtraction method, and factor analysis were compared. Results show that the use of factor analysis improved the SNR in the venous images by a factor of 2.3 compared with the use of simple subtraction. A subjective comparison of the maximum intensity projection images generated from the venous images was also carried out and showed a significant preference for those generated using factor analysis over those generated using other subtraction methods.

Contrast Media↗

PubMed2003

Magnetic resonance imaging of the cervical spinal cord in multiple sclerosis--a quantitative T1 relaxation time mapping approach.

BACKGROUND: The spinal cord is a common site of involvement in multiple sclerosis (MS) where pathology contributes substantially to locomotor disability. Previous studies have demonstrated significant correlations between clinical disability and cervical cord atrophy, but not with cord T(2) lesion load. We evaluate cervical cord pathology using, for the first time, quantitative T(1) relaxation time (T(1)), which shows histopathological specificity for tissue damage in the cerebral white matter. METHOD: Cervical cord T(1) was compared in 15 MS patients [8 relapsing-remitting (RR), 7 secondary progressive (SP)] and 6 healthy controls, and related to normalised upper cervical cord area (UCCa), cerebral white matter T(1), T(2) lesion load and disability measures including the Expanded Disability Status Scale (EDSS), Ambulation index (AI) and timed 25-foot walk. T1 maps of the brain and cervical cord were acquired using a high-resolution, 3-dimensional fast low-angle shot sequence. Dual-echo sequences were also obtained. RESULTS: Median cervical cord T(1) [mean (standard deviation)] was significantly greater in RR [854 [28] ms] (p = 0.0006) and SP patients [927 [67] ms] (p < 0.0001) compared with controls [888 [61] ms], and in SP vs. RR patients (p = 0.002). In the overall patient cohort, it correlated significantly with median cerebral white matter T1 (r = 0.7, p = 0.0046), UCCa (r = -0.87, p < 0.0001), but not T2 lesion loads. Both median cervical cord T1 and UCCa (respectively) correlated significantly with the EDSS (r = 0.55, p = 0.03; r = -0.54, p = 0.04), AI (r = 0.77, p = 0.001; r = -0.60, p = 0.02) and timed 25-foot walk (r = 0.56, p = 0.03; r = -0.55, p = 0.04). CONCLUSION: Cervical cord T(1) distinguishes between MS subgroups and could also prove a useful surrogate outcome measure in MS. The relation of cervical cord T(1) to cerebral white matter T(1) suggests that cord pathology may be influenced by tissue damage upstream.

Adult↗