ArticleNeurology2025
Neurodegeneration and Demyelination in the Multiple Sclerosis Spinal Cord: Clinical, Pathological, and 7T MRI Perspectives.
Article in Neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- M2 polarization of macrophages: Manipulation of spinal cord injury repair.Neural regeneration research · 2026Article
- Standard Model Imaging in the Brain and Spinal Cord of MS Patients: Initial Assessment and Comparison to Diffusion Tensor Imaging.NMR in biomedicine · 2026Article
- Early Combined B-Cell Depletion and BTK Inhibition Reduced TLS-like Structures and Relapse in PLPInternational journal of molecular sciences · 2026Article
- Charting Cervical Spinal Cord Morphometry Across the Lifespan.bioRxiv : the preprint server for biology · 2026Article
- A pipeline to characterize spinal cord pathology in neurological disorders combining magnetic resonance microscopy and histopathology.Communications medicine · 2026Article
- Multimodal MR imaging for quantification of brain lipid in mice at 9.4T.Journal of translational medicine · 2025Article
- Multimodal MR Imaging for quantification of brain lipid in mice at 9.4T.bioRxiv : the preprint server for biology · 2025Article
- Demyelinated lesion associated compartmental inflammation in progressive multiple sclerosis brains.Acta neuropathologica communications · 2025Article
- Adsorption of Myelin Basic Protein on Model Myelin Membranes Reveals Weakening of van der Waals Interactions in a Lipid Ratio-Dependent Manner.Membranes · 2025Article
- Neural Stem Cell-Derived Extracellular Vesicles for Advanced Neural Repair.Journal of neurochemistry · 2025Review
- Association of Spinal Cord Radiomic Features and Disability in Multiple Sclerosis.Journal of neuroimaging : official journal of the American Society of NeuroimagingArticle
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8 authors.
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Abstract
BACKGROUND AND
objectivesKey findings in people with multiple sclerosis (MS) with progressive motor disability are spinal cord (SC) atrophy signifying irreversible axonal loss and SC demyelinated lesions. This study aimed to identify neurodegenerative changes and assess the clinical impact and pathologic characteristics of SC lesions.
methodsA cross-sectional study was performed using postmortem cervical cord segments from the Cleveland Clinic MS Rapid Autopsy Program. Inclusion included proximity to our center, absence of transmissible infections, and lack of prolonged hypoxia. In situ MRIs were performed before tissue removal and fixation followed by 7T MRI and immunohistochemistry. Quantitative T2* relaxation times were correlated with myelin, axons, and activated microglia/macrophages (major histocompatibility complex II [MHCII]) using Tukey comparison of means and a linear mixed-effects model; T2* was correlated with clinical disease characteristics using Wilcoxon rank sum.
resultsThe study included 40 MS cases (median age 58, female 55%) and 9 controls (median age 69, female 89%). A T2* threshold reliably discriminated demyelination (accuracy 89.7%, sensitivity 95.5%, and specificity 87.0%). Myelin content (95% CI -0.82 to -0.58, estimate -0.70) was the only significant predictor of T2*. T2* hyperintensities within the segments ranged from 0% to 100% (median 33.6, interquartile range 12.9-64.3) with only 57.1% demyelinated. T2*-hyperintense/myelinated regions had increased T2* relaxation time (19.2 ms, 95% CI 9.97-28.4), reduced myelin content (-8.3%, 95% CI -12.1 to -4.4), increased MHCII (3.6%, 95% CI 0.45-6.7), reduced axonal counts (-349.8, 95% CI -565.4 to -134.1), and increased axonal area (2.0 µm DISCUSSION: Thresholding 7T T2* postmortem MRI can effectively discriminate demyelinated lesions which correlate with clinical disability and cord atrophy. T2*-hyperintense/myelinated regions exhibit myelin and axonal pathology in periplaque or tract-based distributions suggestive of neurodegeneration. Limitations include sampling of 2-cm of SC across participants making conclusions about proximal and distal pathology difficult.
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