Anterior horn atrophy in the cervical spinal cord: A new biomarker in progressive multiple sclerosis

Charidimos Tsagkas, Antal Huck-Horvath, Alessandro Cagol, Tanja Haas, Muhamed Barakovic, Michael Amann, Esther Ruberte, Lester Melie-Garcia, Matthias Weigel, Simon Pezold, Regina Schlaeger, Jens Kuhle, Till Sprenger, Ludwig Kappos, Oliver Bieri, Philippe Cattin, Cristina Granziera, Katrin Parmar

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Spinal cord (SC) gray and white matter pathology plays a central role in multiple sclerosis (MS). Objective: We aimed to investigate the extent, pattern, and clinical relevance of SC gray and white matter atrophy in vivo. Methods: 39 relapsing–remitting patients (RRMS), 40 progressive MS patients (PMS), and 24 healthy controls (HC) were imaged at 3T using the averaged magnetization inversion recovery acquisitions sequence. Total and lesional cervical gray and white matter, and posterior (SCPH) and anterior horn (SCAH) areas were automatically quantified. Clinical assessment included the expanded disability status scale, timed 25-foot walk test, nine-hole peg test, and the 12-item MS walking scale. Results: PMS patients had significantly reduced cervical SCAH — but not SCPH — areas compared with HC and RRMS (both p < 0.001). In RRMS and PMS, the cervical SCAH areas increased significantly less in the region of cervical SC enlargement compared with HC (all p < 0.001). This reduction was more pronounced in PMS compared with RRMS (both p < 0.001). In PMS, a lower cervical SCAH area was the most important magnetic resonance imaging (MRI)-variable for higher disability scores. Conclusion: MS patients show clinically relevant cervical SCAH atrophy, which is more pronounced in PMS and at the level of cervical SC enlargement.

Original languageEnglish
Pages (from-to)702-718
Number of pages17
JournalMultiple Sclerosis Journal
Issue number6
StatePublished - May 2023
Externally publishedYes


  • Spinal cord
  • atrophy
  • biomarkers
  • demyelination
  • gray matter
  • motor neuron
  • multiple sclerosis
  • neurodegeneration


Dive into the research topics of 'Anterior horn atrophy in the cervical spinal cord: A new biomarker in progressive multiple sclerosis'. Together they form a unique fingerprint.

Cite this