A Gender-Based 3T MRI Comparison Of Brain And Spinal Cord Involvement In Relapsing-Remitting Multiple Sclerosis (S13.001)

Objective: To compare men and women with relapsing-remitting (RR) multiple sclerosis (MS) by brain and spinal cord 3T MRI measures of lesions and atrophy. Background: Studies have reported a higher prevalence of MS in women than men, but more severe physical and cognitive disease progression is observed in men. MRI may be able to capture clinically relevant neurodegenerative aspects of the disease to compare the detrimental effects of MS between genders. Methods: 3D-MDEFT and FLAIR brain, and T2-spinal cord images were acquired at 3T on 36 women [age (mean±SD) 40±8 years, disease duration 8.3±6.8 years, EDSS score 1.2±0.9] and 16 men with RRMS (age 41±9 years, disease duration 8.0±8.3 years, EDSS score 1.2±1.0). Normalized fractions of cerebral gray matter (GMF), white matter (WMF), and total brain parenchyma (BPF) were derived with SPM8 software after correcting misclassification errors related to T1-hypointense lesions and deep GM from MDEFT images. Brain T1-hypointense and FLAIR hyperintense lesion volumes were derived using a semi-automated method. Normalized spinal cord area (SCA) from C2-C5 was determined by an active surface method from T2-cord images. Differences in MRI variables were compared between women and men after controlling for age and disease duration. Results: The two groups were well matched on age, disease duration, and level of physical disability. GMF was significantly lower in men (0.506±0.040) compared to women (0.525±0.024) with RRMS (p=0.036). However, no gender-based differences were found in BPF (p=0.2), WMF (p=0.4), SCA (p=0.2), T1 lesions (p=0.6) and FLAIR lesions (p=0.8). Conclusions: These data suggest that the cerebral GM may be disproportionately vulnerable to neurodegenerative aspects in men vs. women with MS. We hypothesize that the observed differences may be related to differential effects of repair capacity related to sex hormones. Disclosure: Dr. Ceccarelli has nothing to disclose. Dr. Kim has nothing to disclose. Dr. Miller has nothing to disclose. Dr. Tauhid has nothing to disclose. Dr. Chitnis has received personal compensation for activities with Biogen Idec, Novartis, Sanofi-Aventis Pharmaceuticals, Inc., EMD Serono, and Teva Neuroscience as a consultant. Dr. Chitnis has received research support from Merck & Co., Inc. Dr. Neema has nothing to disclose. Dr. Bakshi has received personal compensation for activities with Biogen Idec, Novartis, Sanofi-Aventis Pharmaceuticals, Inc., and Teva Neuroscience. Dr. Bakshi has received personal compensation in an editorial capacity for Neurotherapeutics. Dr. Bakshi has received research support from Biogen Idec, EMD Serono, Novartis, and Teva Neuroscience.