SPINE: Spinal cord imaging to Identify Novel biomarkers of disease Evolution and treatment monitoring in progressive MS

Project Summary:

The spinal cord is core to the central nervous system, whose damage is likely to be one of the major determinants of disability in MS. Abnormalities in the spinal cord, seen upon imaging, have been described in up to 90% of MS patients, and previous studies have consistently demonstrated that the cervical portion of the cord (near the neck) is more affected than lower segments. This damage is with particularly pronounced in progressive MS and also significantly associated with clinical disability.

Spinal cord magnetic resonance imaging (MRI) is still suboptimal due to the many challenges, including those related to the standardization of cord MRI acquisition protocols across different centers. This project aims to establish an international neuroimaging network, involving centres with internationally recognized expertise (San Raffaele Scientific Institute, Milan, Italy; VU Medical Centre, Amsterdam, The Netherlands; Hospital Clinic of Barcelona, Barcelona, Spain; UCL Institute of Neurology, London, UK; Second University of Naples, Naples, Italy; Oxford University Hospitals NHS Trust, Oxford University, Oxford, UK), with the major goal to determine and validate novel cervical cord MRI biomarkers to be utilized as predictors and/or outcomes in future studies of progressive MS.

The cervical cord MRI protocol will be specifically designed for a comprehensive evaluation of cord damage, including lesions, normal-appearing cord tissue and atrophy of different cord compartments (i.e., white matter and gray matter). This approach will increase understanding of the mechanisms linking spinal cord damage to clinical disability and its progression over time, further enabling both pharmacological as well as rehabilitative strategies in progressive MS.