{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T22:35:13Z","timestamp":1793831713672,"version":"4.6.1"},"reference-count":34,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,1,18]],"date-time":"2025-01-18T00:00:00Z","timestamp":1737158400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000871","name":"Mayo Clinic","doi-asserted-by":"publisher","award":["Eugene and Marcia Applebaum Award"],"award-info":[{"award-number":["Eugene and Marcia Applebaum Award"]}],"id":[{"id":"10.13039\/100000871","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIH","award":["K12 AR084222"],"award-info":[{"award-number":["K12 AR084222"]}]},{"name":"NIH","award":["U54 AG044170"],"award-info":[{"award-number":["U54 AG044170"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Spinal cord (SC) atrophy is a key imaging biomarker of progressive multiple sclerosis (MS). Progressive MS is more common in men and postmenopausal women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Investigate the impact of sex and menopause on SC measurements in persons with MS (pwMS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      In pwMS and age- and sex-matched controls, upper cervical SC area from brain MRI (UCC\n                      <jats:sub>brain<\/jats:sub>\n                      ) was obtained. Impact of sex and menopause on UCC\n                      <jats:sub>brain<\/jats:sub>\n                      (adjusted for total intracranial volume) and its association with progression and disability, including MS functional composite (MSFC), were investigated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      UCC\n                      <jats:sub>brain<\/jats:sub>\n                      was smaller in pwMS (\n                      <jats:italic>n<\/jats:italic>\n                      = 118, 51.4 \u00b1 5.3 mm\n                      <jats:sup>2<\/jats:sup>\n                      ) than controls (\n                      <jats:italic>n<\/jats:italic>\n                      = 118, 54.2 \u00b1 4.4 mm\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) and inversely correlated with older age in pwMS (\n                      <jats:italic>r<\/jats:italic>\n                      = \u22120.24,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.010) but not in controls (\n                      <jats:italic>r<\/jats:italic>\n                      = \u22120.025,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.786). In 173 pwMS (413 brain MRIs), UCC\n                      <jats:sub>brain<\/jats:sub>\n                      was smaller in men (49.5 \u00b1 5.9 mm\n                      <jats:sup>2<\/jats:sup>\n                      ) than women (51.6 \u00b1 5.5 mm\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001), postmenopausal women (49.4 \u00b1 5.6 mm\n                      <jats:sup>2<\/jats:sup>\n                      ) than premenopausal women (52.9 \u00b1 4.1 mm\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), and progressive (47.5 \u00b1 5.6 mm\n                      <jats:sup>2<\/jats:sup>\n                      ) than relapsing MS (52.1 \u00b1 5.2 mm\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). UCC\n                      <jats:sub>brain<\/jats:sub>\n                      also correlated with disease duration (\n                      <jats:italic>r<\/jats:italic>\n                      = \u22120.39,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), 9-hole peg test (\n                      <jats:italic>r<\/jats:italic>\n                      = \u22120.26,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.005), and severe ambulatory disability (Expanded Disability Status Scale \u2a7e6) (\n                      <jats:italic>r<\/jats:italic>\n                      = \u22120.27,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      UCC\n                      <jats:sub>brain<\/jats:sub>\n                      , a biomarker of progressive MS, is inversely associated with age, disease duration, male sex, and menopause, highlighting the potential impact of sex and hormones on neurodegeneration in MS.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585241311441","type":"journal-article","created":{"date-parts":[[2025,1,18]],"date-time":"2025-01-18T04:39:21Z","timestamp":1737175161000},"page":"278-289","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Upper cervical spinal cord atrophy in MS: Sex, menopause, and neurodegeneration"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2270-9868","authenticated-orcid":false,"given":"Burcu","family":"Zeydan","sequence":"first","affiliation":[{"name":"Department of Radiology, Mayo Clinic, Rochester, MN, USA"},{"name":"Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN, USA"},{"name":"Women\u2019s Health Research Center, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiye","family":"Son","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2959-4271","authenticated-orcid":false,"given":"Nur","family":"Neyal","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1466-8357","authenticated-orcid":false,"given":"Christopher G","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1191-3775","authenticated-orcid":false,"given":"Elizabeth J","family":"Atkinson","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly A","family":"Morrison","sequence":"additional","affiliation":[{"name":"Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6446-1146","authenticated-orcid":false,"given":"Nabeela","family":"Nathoo","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kejal","family":"Kantarci","sequence":"additional","affiliation":[{"name":"Department of 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