Clinical research emphasizes the implementation of rigorous and reproducible study designs that rely on between-group matching or controlling for sources of biological variation such as subject's sex and age. However, corrections for body size (i.e. height and weight) are mostly lacking in clinical neuroimaging designs. This study investigates the importance of body size parameters in their relationship with spinal cord (SC) and brain magnetic resonance imaging (MRI) metrics. Data were derived from a cosmopolitan population of 267 healthy human adults (age 30.1±6.6 years old, 125 females). We show that body height correlated strongly or moderately with brain gray matter (GM) volume, cortical GM volume, total cerebellar volume, brainstem volume, and cross-sectional area (CSA) of cervical SC white matter (CSA-WM; 0.44≤r≤0.62). In comparison, age correlated weakly with cortical GM volume, precentral GM volume, and cortical thickness (-0.21≥r≥-0.27). Body weight correlated weakly with magnetization transfer ratio in the SC WM, dorsal columns, and lateral corticospinal tracts (-0.20≥r≥-0.23). Body weight further correlated weakly with the mean diffusivity derived from diffusion tensor imaging (DTI) in SC WM (r=-0.20) and dorsal columns (-0.21), but only in males. CSA-WM correlated strongly or moderately with brain volumes (0.39≤r≤0.64), and weakly with precentral gyrus thickness and DTI-based fractional anisotropy in SC dorsal columns and SC lateral corticospinal tracts (-0.22≥r≥-0.25). Linear mixture of sex and age explained 26±10% of data variance in brain volumetry and SC CSA. The amount of explained variance increased at 33±11% when body height was added into the mixture model. Age itself explained only 2±2% of such variance. In conclusion, body size is a significant biological variable. Along with sex and age, body size should therefore be included as a mandatory variable in the design of clinical neuroimaging studies examining SC and brain structure.

1st Department of Neurology St Anne's University Hospital and Medical Faculty of Masaryk University Brno Czech Republic

Advanced Imaging and Artificial Intelligence Center Neuroradiology Department IRCCS Mondino Foundation Pavia Italy

Aix Marseille Univ CNRS CRMBM Marseille France

APHM Hopital Universitaire Timone CEMEREM Marseille France

Athinoula A Martinos Center for Biomedical Imaging Department of Radiology Massachusetts General Hospital Charlestown Massachusetts USA

Biomedical Engineering and Imaging Institute Department of Radiology Graduate School of Biomedical Sciences Icahn School of Medicine at Mount Sinai New York USA

Canon Medical Systems srl Rome Italy

Cardiff University Brain Research Imaging Centre School of Psychology Cardiff University Cardiff Wales UK

CAS Key Laboratory of Behavioral Science Institute of Psychology Chinese Academy of Science Beijing 100101 China

Center for Magnetic Resonance Research Department of Radiology University of Minnesota Minneapolis MN USA

Centre de recherche du CHU Sainte Justine Université de Montréal Montreal QC Canada

Centre for Advanced Imaging Australian Institute for Bioengineering and Nanotechnology The University of Queensland St Lucia Australia

Centre for Human Brain Health University of Birmingham Birmingham UK

Centre for Medical Image Computing University College London London UK

Centre of Precision Rehabilitation for Spinal Pain University of Birmingham Birmingham UK

Clement J Zablocki Veteran's Affairs Medical Center Milwaukee WI USA

CREF Museo storico della fisica e Centro studi e ricerche Enrico Fermi Rome Italy

Department for Systems Neuroscience University Medical Center Hamburg Eppendorf Hamburg Germany

Department of Biomedical Engineering Vanderbilt University Nashville TN USA

Department of Biomedical Sciences Humanitas University Via Rita Levi Montalcini 4 20072 Pieve Emanuele Italy

Department of Biophysics Faculty of Medicine Masaryk University Brno Czech Republic

Department of Brain and Behavioural Sciences University of Pavia Pavia Italy

Department of Computer Engineering and Software Engineering Polytechnique Montreal Montreal QC Canada

Department of Neurological Surgery University of California Davis CA USA

Department of Neurology Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic

Department of Neurology UCSF Weill Institute for Neurosciences University of California San Francisco San Francisco CA USA

Department of Neurology University Hospital Brno Brno Czech Republic

Department of Neurophysics Max Planck Institute for Human Cognitive and Brain Sciences Stephanstraße 1a 04103 Leipzig Germany

Department of Neurosciences Imaging and Clinical Sciences 'G D'Annunzio' University of Chieti Pescara Chieti Italy

Department of Neurosurgery Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic

Department of Neurosurgery Medical College of Wisconsin Milwaukee WI USA

Department of Neurosurgery University of Oklahoma Oklahoma City OK USA

Department of Pathology and Laboratory Medicine University of British Columbia Vancouver Canada

Department of Physics and Astronomy University of British Columbia Vancouver BC Canada

Department of Psychiatry Baylor College of Medicine Houston Texas USA

Department of Psychology University of Chinese Academy of Sciences Beijing 100049 China

Department of Radiology and Medical Informatics Faculty of Medicine University of Geneva Switzerland

Department of Radiology and Nuclear Medicine University Hospital Brno and Masaryk University Czech Republic

Department of Radiology and Radiological Sciences Vanderbilt University Medical Center Nashville TN USA

Department of Radiology Baylor College of Medicine Houston Texas USA

Department of Radiology Beijing Tiantan Hospital Capital Medical University China

Department of Radiology Faculty of Medicine University of British Columbia Vancouver BC Canada

Department of Radiology Juntendo University School of Medicine 1 2 1 Hongo Bunkyo Tokyo 113 8421 Japan

Department of Radiology Northwestern University Chicago IL 60611 USA

Department of Radiology Swiss Paraplegic Centre Nottwil Switzerland

Department of Radiology Toho University Omori Medical Center Tokyo Japan

Division of Clinical Behavioral Neuroscience Department of Pediatrics Masonic Institute for the Developing Brain University of Minnesota Minneapolis MN USA

Division of Neurology Faculty of Medicine University of British Columbia Vancouver BC Canada

Division of Pain Medicine Department of Anesthesiology Perioperative and Pain Medicine Stanford University School of Medicine Palo Alto CA USA

e Health Center Universitat Oberta de Catalunya Barcelona Spain

Faculty of Medicine Masaryk University Brno Czech Republic

Felix Bloch Institute for Solid State Physics Faculty of Physics and Earth Sciences Leipzig University Linnéstraße 5 04103 Leipzig Germany

Fondation Campus Biotech Geneva Genève Switzerland

Functional Neuroimaging Unit CRIUGM University of Montreal Montreal Canada

Harvard Massachusetts Institute of Technology Health Sciences and Technology Cambridge Massachusetts USA

Harvard Medical School Boston Massachusetts USA

IBM Poland Department of Content Design Cracow Poland

Institute for Advanced Biomedical Technologies 'G D'Annunzio' University of Chieti Pescara Chieti Italy

Institute for Mental Health University of Birmingham Birmingham UK

Institute of Diagnostic and Interventional Neuroradiology Faculty of Medicine and Carl Gustav Carus University Hospital Technische Universität Dresden Germany

Institute of Nanotechnology CNR Rome Italy

International Collaboration on Repair Discoveries University of British Columbia Vancouver Canada

IRCCS Santa Lucia Foundation Neuroimaging Laboratory Rome Italy

Max Planck Research Group Pain Perception Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany

McConnell Brain Imaging Centre Montreal Neurological Institute McGill University Montreal Quebec Canada

Mila Quebec AI Institute Montreal QC Canada

MR Clinical Science Philips Healthcare Canada Mississauga Canada

Multimodal and Functional Imaging Laboratory Central European Institute of Technology Brno Czech Republic

Neuro 10 Institute Ecole polytechnique fédérale de Lausanne Geneva Switzerland

Neuroimmunology and Multiple Sclerosis Unit Laboratory of Advanced Imaging in Neuroimmunological Diseases Hospital Clinic Barcelona Fundació de Recerca Clínic Barcelona IDIBAPS and Universitat de Barcelona Barcelona Spain

NeuroPoly Lab Institute of Biomedical Engineering Polytechnique Montreal Montreal QC Canada

Neuroradiology Unit IRCCS Humanitas Research Hospital Via Alessandro Manzoni 56 20089 Rozzano Italy

NMR Research Unit Queen Square Multiple Sclerosis Centre Department of Neuroinflammation Queen Square Institute of Neurology Faculty of Brain Sciences University College London UK

School of Biomedical Sciences Faculty of Medicine The University of Queensland St Lucia Australia

School of Electrical Engineering and Computer Science The University of Queensland St Lucia Australia

Section of Neuroradiology Department of Radiology Hospital Universitari Vall d'Hebron Barcelona Spain

Sherbrooke Connectivity Imaging Lab Computer Science department Université de Sherbrooke Sherbrooke QC Canada

Spinal Cord Injury Center Balgrist University Hospital Zurich University of Zurich Zurich Switzerland

Stanford University Stanford CA USA

The University of Tokyo Hospital Radiology Center Tokyo Japan

Université de Strasbourg CNRS ICube Strasbourg France

Vall d'Hebron Institute of Oncology Vall d'Hebron Barcelona Hospital Campus Barcelona Spain

Vanderbilt University Institute of Imaging Science Vanderbilt University Medical Center Nashville TN USA

Wellcome Centre For Integrative Neuroimaging FMRIB Nuffield Department of Clinical Neurosciences University of Oxford Oxford UK

Wellcome Trust Centre for Neuroimaging Queen Square Institute of Neurology University College London London UK

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