BACKGROUND The spinal cord (SC) is highly relevant to disability in multiple sclerosis (MS), but few studies have evaluated longitudinal changes in quantitative spinal cord magnetic resonance imaging (SC-MRI). OBJECTIVES The aim of this study was to characterize the relationships between 5-year changes in SC-MRI with disability in MS. METHODS In total, 75 MS patients underwent 3 T SC-MRI and clinical assessment (expanded disability status scale (EDSS) and MS functional composite (MSFC)) at baseline, 2 and 5 years. SC-cross-sectional area (CSA) and diffusion-tensor indices (fractional anisotropy (FA), mean, perpendicular, parallel diffusivity (MD, λ⊥, λ||) and magnetization transfer ratio (MTR)) were extracted at C3-C4. Mixed-effects regression incorporating subject-specific slopes assessed longitudinal change in SC-MRI measures. RESULTS SC-CSA and MTR decreased (p = 0.009, p = 0.03) over 5.1 years. There were moderate correlations between 2- and 5-year subject-specific slopes of SC-MRI indices and follow-up EDSS scores (Pearson's r with FA = -0.23 (p < 0.001); MD = 0.31 (p < 0.001); λ⊥ = 0.34 (p < 0.001); λ|| = -0.12 (p = 0.05), MTR = -0.37 (p < 0.001); SC-CSA = -0.47 (p < 0.001) at 5 years); MSFC showed similar trends. The 2- and 5-year subject-specific slopes were robustly correlated (r = 0.93-0.97 for FA, λ⊥, SC-CSA and MTR, all ps < 0.001). CONCLUSION In MS, certain quantitative SC-MRI indices change over 5 years, reflecting ongoing tissue changes. Subject-specific trajectories of SC-MRI index change at 2 and 5 years are strongly correlated and highly relevant to follow-up disability. These findings suggest that individual dynamics of change should be accounted for when interpreting longitudinal SC-MRI measures and that measuring short-term change is predictive of long-term clinical disability.

中文翻译：

---

多发性硬化症脊髓 MRI 定量的五年纵向变化

背景脊髓 (SC) 与多发性硬化症 (MS) 的残疾高度相关，但很少有研究评估定量脊髓磁共振成像 (SC-MRI) 的纵向变化。目的 本研究的目的是表征 SC-MRI 的 5 年变化与 MS 残疾之间的关系。方法 总共有 75 名 MS 患者在基线、2 年和 5 年时接受了 3 T SC-MRI 和临床评估（扩展残疾状态量表 (EDSS) 和 MS 功能复合物 (MSFC)）。在 C3-提取 SC 横截面积 (CSA) 和扩散张量指数（分数各向异性 (FA)、平均、垂直、平行扩散率（MD、λ⊥、λ||）和磁化转移率 (MTR)） C4. 结合受试者特定斜率的混合效应回归评估 SC-MRI 测量的纵向变化。结果 SC-CSA 和 MTR 在 5.1 年内下降（p = 0.009，p = 0.03）。SC-MRI 指数的 2 年和 5 年特定主题斜率与后续 EDSS 评分之间存在中等相关性（Pearson's r，FA = -0.23 (p < 0.001)；MD = 0.31 (p < 0.001)；λ ⊥ = 0.34 (p < 0.001); λ|| = -0.12 (p = 0.05), MTR = -0.37 (p < 0.001); SC-CSA = -0.47 (p < 0.001) at 5 years); MSFC 显示出类似的趋势。2 年和 5 年特定学科的斜率密切相关（对于 FA、λ⊥、SC-CSA 和 MTR，r = 0.93-0.97，所有 ps < 0.001）。结论 在 MS 中，某些定量的 SC-MRI 指数在 5 年内发生变化，反映了持续的组织变化。2 年和 5 年时 SC-MRI 指数变化的受试者特定轨迹与随访残疾密切相关且高度相关。