Cognitive Projection of Upper Cervical Spinal Cord Cross-Sectional Area in Multiple Sclerosis

Abstract

Background

Cervical spinal cord atrophy, typically assessed via measurements of the mean upper cervical cord area (MUCCA), is a significant factor in disability and disease progression in multiple sclerosis (MS).

Aim

This study is aimed at exploring the relationship between MUCCA, physical disability, and cognitive impairment in MS.

Materials and Methods

Thirty-one MS patients participated in the study. Upper extremity function was assessed using the Nine-Hole Peg Test (9HPT), while lower extremity function was evaluated with the Timed 25-Foot Walk Test (T25FWT). Cognitive function was measured with the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). MUCCA was measured at two levels (reflecting the mean value of C1 and C2) using 3D T2-weighted magnetic resonance imaging scans.

Results

The study found that MUCCA is associated with cognitive impairment. It was demonstrated that MUCCA predicts EDSS, 9HPT, SDMT, CVLT, and T25FWT outcomes. In addition, age was the significant predictor of all parameters. Cronbach′s alpha values were 0.96 for C1 and 0.98 for C2, indicating excellent internal consistency across the three observers.

Conclusion

These findings demonstrate that spinal cord area measurements are associated with both clinical and cognitive outcomes in MS, even among patients with low disability. Additionally, the observed correlation coefficients indicate excellent reproducibility and strong interobserver agreement for manual measurements.