Cervical spinal cord cross-sectional area correlates with myelin water fraction in progressive multiple sclerosis

Motivation: Advanced MRI techniques may give insight into the mechanisms leading to spinal cord atrophy in multiple sclerosis (MS). Goal(s): To assess myelin damage in relation to cross-sectional area (CSA) in MS cervical cord. Approach: 28 people living with MS and 19 controls were scanned between C1-C5 at 3T using CALIPR. Spinal Cord Toolbox was used to determine CSA and mean MWF at C2-C3. Results: Myelin water fraction at C2-C3 was correlated with cross-sectional area in progressive multiple sclerosis, indicating a possible link between myelin loss and cord atrophy. Impact: By examining both cross-sectional area and myelin water fraction in multiple sclerosis spinal cord, we may be able to differentiate volume loss due to potentially reversible demyelination from irreversible axonal loss.