Burcu Zeydan, Jiye Son, Nur Neyal, Christopher G Schwarz, Elizabeth J Atkinson, Holly A Morrison, Nabeela Nathoo, Kejal Kantarci, Eoin P Flanagan, John D Port, Orhun H Kantarci
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Impact of sex and menopause on UCC<sub>brain</sub> (adjusted for total intracranial volume) and its association with progression and disability, including MS functional composite (MSFC), were investigated.</p><p><strong>Results: </strong>UCC<sub>brain</sub> was smaller in pwMS (<i>n</i> = 118, 51.4 ± 5.3 mm<sup>2</sup>) than controls (<i>n</i> = 118, 54.2 ± 4.4 mm<sup>2</sup>, <i>p</i> < 0.001) and inversely correlated with older age in pwMS (<i>r</i> = -0.24, <i>p</i> = 0.010) but not in controls (<i>r</i> = -0.025, <i>p</i> = 0.786). In 173 pwMS (413 brain MRIs), UCC<sub>brain</sub> was smaller in men (49.5 ± 5.9 mm<sup>2</sup>) than women (51.6 ± 5.5 mm<sup>2</sup>, <i>p</i> = 0.001), postmenopausal women (49.4 ± 5.6 mm<sup>2</sup>) than premenopausal women (52.9 ± 4.1 mm<sup>2</sup>, <i>p</i> < 0.001), and progressive (47.5 ± 5.6 mm<sup>2</sup>) than relapsing MS (52.1 ± 5.2 mm<sup>2</sup>, <i>p</i> < 0.001). UCC<sub>brain</sub> also correlated with disease duration (<i>r</i> = -0.39, <i>p</i> < 0.001), 9-hole peg test (<i>r</i> = -0.26, <i>p</i> = 0.005), and severe ambulatory disability (Expanded Disability Status Scale ⩾6) (<i>r</i> = -0.27, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>UCC<sub>brain</sub>, a biomarker of progressive MS, is inversely associated with age, disease duration, male sex, and menopause, highlighting the potential impact of sex and hormones on neurodegeneration in MS.</p>","PeriodicalId":18874,"journal":{"name":"Multiple Sclerosis Journal","volume":" ","pages":"278-289"},"PeriodicalIF":4.8000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919563/pdf/","citationCount":"0","resultStr":"{\"title\":\"Upper cervical spinal cord atrophy in MS: Sex, menopause, and neurodegeneration.\",\"authors\":\"Burcu Zeydan, Jiye Son, Nur Neyal, Christopher G Schwarz, Elizabeth J Atkinson, Holly A Morrison, Nabeela Nathoo, Kejal Kantarci, Eoin P Flanagan, John D Port, Orhun H Kantarci\",\"doi\":\"10.1177/13524585241311441\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Spinal cord (SC) atrophy is a key imaging biomarker of progressive multiple sclerosis (MS). Progressive MS is more common in men and postmenopausal women.</p><p><strong>Objective: </strong>Investigate the impact of sex and menopause on SC measurements in persons with MS (pwMS).</p><p><strong>Methods: </strong>In pwMS and age- and sex-matched controls, upper cervical SC area from brain MRI (UCC<sub>brain</sub>) was obtained. Impact of sex and menopause on UCC<sub>brain</sub> (adjusted for total intracranial volume) and its association with progression and disability, including MS functional composite (MSFC), were investigated.</p><p><strong>Results: </strong>UCC<sub>brain</sub> was smaller in pwMS (<i>n</i> = 118, 51.4 ± 5.3 mm<sup>2</sup>) than controls (<i>n</i> = 118, 54.2 ± 4.4 mm<sup>2</sup>, <i>p</i> < 0.001) and inversely correlated with older age in pwMS (<i>r</i> = -0.24, <i>p</i> = 0.010) but not in controls (<i>r</i> = -0.025, <i>p</i> = 0.786). In 173 pwMS (413 brain MRIs), UCC<sub>brain</sub> was smaller in men (49.5 ± 5.9 mm<sup>2</sup>) than women (51.6 ± 5.5 mm<sup>2</sup>, <i>p</i> = 0.001), postmenopausal women (49.4 ± 5.6 mm<sup>2</sup>) than premenopausal women (52.9 ± 4.1 mm<sup>2</sup>, <i>p</i> < 0.001), and progressive (47.5 ± 5.6 mm<sup>2</sup>) than relapsing MS (52.1 ± 5.2 mm<sup>2</sup>, <i>p</i> < 0.001). UCC<sub>brain</sub> also correlated with disease duration (<i>r</i> = -0.39, <i>p</i> < 0.001), 9-hole peg test (<i>r</i> = -0.26, <i>p</i> = 0.005), and severe ambulatory disability (Expanded Disability Status Scale ⩾6) (<i>r</i> = -0.27, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>UCC<sub>brain</sub>, a biomarker of progressive MS, is inversely associated with age, disease duration, male sex, and menopause, highlighting the potential impact of sex and hormones on neurodegeneration in MS.</p>\",\"PeriodicalId\":18874,\"journal\":{\"name\":\"Multiple Sclerosis Journal\",\"volume\":\" \",\"pages\":\"278-289\"},\"PeriodicalIF\":4.8000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919563/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Multiple Sclerosis Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/13524585241311441\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/18 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Multiple Sclerosis Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/13524585241311441","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/18 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：脊髓（SC）萎缩是进行性多发性硬化症（MS）的关键影像生物标志物。进行性多发性硬化症在男性和绝经后女性中更为常见。目的：探讨性别和更年期对多发性硬化症（pwMS）患者SC测量的影响。方法：在pwMS和年龄、性别匹配的对照组中，通过脑MRI （UCCbrain）获取上颈椎SC区。研究了性别和更年期对UCCbrain（经颅内总容积调整）的影响及其与进展和残疾（包括MS功能复合（MSFC））的关系。结果：pwMS患者UCCbrain （n = 118, 51.4±5.3 mm2）小于对照组（n = 118, 54.2±4.4 mm2, p < 0.001），与年龄呈负相关（r = -0.24, p = 0.010），而对照组无相关（r = -0.025, p = 0.786）。在173张pwMS（413张脑mri）中，男性UCCbrain（49.5±5.9 mm2）小于女性（51.6±5.5 mm2, p = 0.001），绝经后女性（49.4±5.6 mm2）小于绝经前女性（52.9±4.1 mm2, p < 0.001），进行性（47.5±5.6 mm2）小于复发性MS（52.1±5.2 mm2, p < 0.001）。UCCbrain还与疾病持续时间（r = -0.39, p < 0.001）、9孔栓试验（r = -0.26, p = 0.005）和严重的动态残疾（扩展残疾状态量表大于或等于6）（r = -0.27, p < 0.001）相关。结论：UCCbrain是进展性MS的生物标志物，与年龄、病程、男性和绝经期呈负相关，突出了性别和激素对MS神经退行性变的潜在影响。
Upper cervical spinal cord atrophy in MS: Sex, menopause, and neurodegeneration.
Background: Spinal cord (SC) atrophy is a key imaging biomarker of progressive multiple sclerosis (MS). Progressive MS is more common in men and postmenopausal women.
Objective: Investigate the impact of sex and menopause on SC measurements in persons with MS (pwMS).
Methods: In pwMS and age- and sex-matched controls, upper cervical SC area from brain MRI (UCCbrain) was obtained. Impact of sex and menopause on UCCbrain (adjusted for total intracranial volume) and its association with progression and disability, including MS functional composite (MSFC), were investigated.
Results: UCCbrain was smaller in pwMS (n = 118, 51.4 ± 5.3 mm2) than controls (n = 118, 54.2 ± 4.4 mm2, p < 0.001) and inversely correlated with older age in pwMS (r = -0.24, p = 0.010) but not in controls (r = -0.025, p = 0.786). In 173 pwMS (413 brain MRIs), UCCbrain was smaller in men (49.5 ± 5.9 mm2) than women (51.6 ± 5.5 mm2, p = 0.001), postmenopausal women (49.4 ± 5.6 mm2) than premenopausal women (52.9 ± 4.1 mm2, p < 0.001), and progressive (47.5 ± 5.6 mm2) than relapsing MS (52.1 ± 5.2 mm2, p < 0.001). UCCbrain also correlated with disease duration (r = -0.39, p < 0.001), 9-hole peg test (r = -0.26, p = 0.005), and severe ambulatory disability (Expanded Disability Status Scale ⩾6) (r = -0.27, p < 0.001).
Conclusion: UCCbrain, a biomarker of progressive MS, is inversely associated with age, disease duration, male sex, and menopause, highlighting the potential impact of sex and hormones on neurodegeneration in MS.
期刊介绍：
Multiple Sclerosis Journal is a peer-reviewed international journal that focuses on all aspects of multiple sclerosis, neuromyelitis optica and other related autoimmune diseases of the central nervous system.
The journal for your research in the following areas:
* __Biologic basis:__ pathology, myelin biology, pathophysiology of the blood/brain barrier, axo-glial pathobiology, remyelination, virology and microbiome, immunology, proteomics
* __Epidemology and genetics:__ genetics epigenetics, epidemiology
* __Clinical and Neuroimaging:__ clinical neurology, biomarkers, neuroimaging and clinical outcome measures
* __Therapeutics and rehabilitation:__ therapeutics, rehabilitation, psychology, neuroplasticity, neuroprotection, and systematic management
Print ISSN: 1352-4585
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