ORIGINAL RESEARCH Medulla Oblongata Volume: A Biomarker of Spinal Cord Damage and Disability in Multiple Sclerosis

RESULTS: In the patients, MOV correlated significantly with UCCV (r 0.67), BPF (r 0.45), disease duration (r 0.64), age (r 0.47), EDSS score (r 0.49) and AI (r 0.52). Volume loss of the medulla oblongata was 0.008 cm3/year of age in patients with MS, but no significant linear relationship with age was found for healthy control subjects. The patients had a smaller MOV (mean SD, 1.02 0.17 cm3) than healthy control subjects (1.15 0.15 cm3), though BPF was unable to distinguish between these 2 groups. MOV was smaller in patients with progressive MS (secondary- progressive MS, 0.88 0.19 cm3 and primary-progressive MS, 0.95 0.30 cm3) than in patients with relapsing-remitting MS (1.08 0.15 cm3). A model including both MOV and BPF better predicted AI than BPF alone (P.04). Good reproducibility in MOV measurements was demonstrated for intrarater (intraclass correlation coefficient, 0.97), interrater (0.79), and scan rescan data (0.81). CONCLUSION: MOV is associated with disability in MS and can serve as a biomarker of spinal cord damage.