{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T23:36:50Z","timestamp":1790897810526,"version":"4.1.0"},"reference-count":51,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,6,29]],"date-time":"2025-06-29T00:00:00Z","timestamp":1751155200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009408","name":"Fondation Brain Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009408","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000261","name":"Multiple Sclerosis Society of Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000261","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013200","name":"Government of Alberta","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013200","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005614","name":"Biogen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005614","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The cervical spinal cord (cSC) is highly relevant to clinical dysfunction in multiple sclerosis (MS) but remains understudied using quantitative magnetic resonance imaging (MRI). We assessed magnetization transfer ratio (MTR), a semi\u2010quantitative MRI measure sensitive to MS\u2010related tissue microstructural changes, in the cSC and its relationship with clinical outcomes in radiologically isolated syndrome (RIS) and MS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>MTR data were acquired from 52 RIS, 201 relapsing\u2013remitting MS (RRMS), 47 primary progressive MS (PPMS), and 43 control (CON) participants across four sites in the Canadian Prospective Cohort Study to Understand Progression in MS (CanProCo) using 3.0\u2009T MRI systems. Mean MTR was compared between groups in whole cSC and sub\u2010regions between C2\u2010C4. Multiple linear regression was used to evaluate relationships between MTR and clinical outcomes, including the expanded disability status scale (EDSS), walking speed test (WST), and manual dexterity test (MDT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were consistent group differences in MTR, which were most pronounced between PPMS and CON (\u22125.8% to \u22123.7%, <jats:italic>p<\/jats:italic>\u2009\u2264\u20090.01). In PPMS, lower MTR was associated with greater disability as measured by EDSS (<jats:italic>\u03b2<\/jats:italic>\u2009=\u2009\u22120.3 to \u22120.1, <jats:italic>p<\/jats:italic>\u2009\u2264\u20090.03), WST (<jats:italic>\u03b2<\/jats:italic>\u2009=\u2009\u22120.9 to \u22120.5, <jats:italic>p<\/jats:italic>\u2009\u2264\u20090.04), and MDT (<jats:italic>\u03b2<\/jats:italic>\u2009=\u2009\u22120.6 and\u2009\u2212\u20090.5, <jats:italic>p<\/jats:italic>\u2009=\u20090.04). In RRMS, MTR was associated with only EDSS (<jats:italic>\u03b2<\/jats:italic>\u2009=\u2009\u22120.1, <jats:italic>p<\/jats:italic>\u2009\u2264\u20090.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>In this large sample of RIS and MS, cSC MTR was lowest in PPMS, with associations between MTR and clinical outcomes in MS but not RIS. These findings suggest that MTR provides important information about the underlying tissue microstructural integrity of the cSC relevant to clinical disability in established MS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.70113","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T01:39:17Z","timestamp":1751247557000},"page":"1794-1804","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cervical Spinal Cord Magnetization Transfer Ratio and Its Relationship With Clinical Outcomes in Multiple Sclerosis"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8334-3740","authenticated-orcid":false,"given":"Lisa Eunyoung","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Medicine (Neurology) University of Toronto  Toronto Ontario Canada"},{"name":"BARLO Multiple Sclerosis Centre St. Michael's Hospital, Unity Health Toronto  Toronto Ontario Canada"},{"name":"Keenan Research Centre St. Michael's Hospital, Unity Health Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Cohen\u2010Adad","sequence":"additional","affiliation":[{"name":"NeuroPoly Lab Institute of Biomedical Engineering, Polytechnique Montr\u00e9al  Montreal QC Canada"},{"name":"Functional Neuroimaging Unit CRIUGM  Montreal QC Canada"},{"name":"Mila\u2010Quebec AI Institute  Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene M.","family":"Vavasour","sequence":"additional","affiliation":[{"name":"Department of Radiology University of British Columbia  Vancouver B.C. 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