Spinal cord magnetic resonance imaging demonstrates sensory neuronal involvement and clinical severity in neuronopathy associated with Sjogren's syndrome

Objectives-To determine spinal cord MRI findings in neuronopathy associated with Sjogren's syndrome and their correlation with severity of sensory imp airment. Methods-Clinical and electrophysiological features, pathological findings i n the sural nerve, and hyperintensity on T2(star) weighted MRI in the spina l dorsal columns were evaluated in 14 patients with neuronopathy associated with Sjogren's syndrome. Results-Of 14 patients, 12 showed high intensity by T2(star) weighted MRI i n the posterior columns of the cervical cord. High intensity areas were see n in both the fasciculus cuneatus and gracilis in nine patients, who showed severe and widespread sensory deficits in the limbs and trunk; these patie nts also had a high frequency of autonomic symptoms. Somatosensory evoked p otentials often could not be elicited. Hyperintensity restricted to the fas ciculus gracilis was seen in three patients, who showed sensory deficits re stricted to lower limbs without trunk involvement, or with only partial lim b involvement; no autonomic symptoms were noted. The two patients who did n ot show high intensity areas in the dorsal columns showed restricted sensor y involvement in the limbs. All patients showed axonal loss predominantly a ffecting large fibres, without axonal sprouting. Conclusions-High intensity areas on T2(star) weighted MRI in the spinal dor sal columns reflect the degree of sensory neuronal involvement in neuronopa thy associated with Sjogren's syndrome; this finding could also be a helpfu l marker for estimating severity of this neuronopathy.