BACKGROUND: The usefulness of performing a spinal cord (SC) magnetic resonance imaging (MRI) in all clinically isolated syndromes (CIS) is controversial. OBJECTIVE: To assess the value of SC lesions for predicting multiple sclerosis (MS) diagnosis and disability accrual in CIS. METHODS: Concerning SC lesions and MS diagnosis (2010 McDonald), adjusted Cox regression analyses were performed in increasingly specific CIS groups: all cases ( n = 207), non-SC CIS ( n = 143), non-SC CIS with abnormal brain MRI ( n = 90) and non-SC CIS with abnormal brain MRI not fulfilling 2010 MS ( n = 67). For the outcome Expanded Disability Status Scale (EDSS) ≥3.0, similar analyses were performed in all cases ( n = 207), non-SC CIS ( n = 143) and SC CIS ( n = 64). Performance at 2 years was assessed for all outcomes. RESULTS: The presence of SC lesions increased MS risk 2.0-2.6 times independently of factors like brain lesions. If considering lesion number, the risk ranged from 1.6 to 2.1 for one lesion to 2.4-3.3 for ≥2. SC lesions increased the short-term disability risk around fivefold, better demonstrated in non-SC CIS. SC lesions were very specific for evolution to MS and showed very high sensitivity for EDSS ≥3.0. CONCLUSION: SC lesions are independent predictors of MS in all CIS and contribute to short-term disability accrual. SC MRIs in CIS could be useful to estimate their prognosis.
BACKGROUND: The usefulness of performing a spinal cord (SC) magnetic resonance imaging (MRI) in all clinically isolated syndromes (CIS) is controversial. OBJECTIVE: To assess the value of SC lesions for predicting multiple sclerosis (MS) diagnosis and disability accrual in CIS. METHODS: Concerning SC lesions and MS diagnosis (2010 McDonald), adjusted Cox regression analyses were performed in increasingly specific CIS groups: all cases ( n = 207), non-SC CIS ( n = 143), non-SC CIS with abnormal brain MRI ( n = 90) and non-SC CIS with abnormal brain MRI not fulfilling 2010 MS ( n = 67). For the outcome Expanded Disability Status Scale (EDSS) ≥3.0, similar analyses were performed in all cases ( n = 207), non-SC CIS ( n = 143) and SC CIS ( n = 64). Performance at 2 years was assessed for all outcomes. RESULTS: The presence of SC lesions increased MS risk 2.0-2.6 times independently of factors like brain lesions. If considering lesion number, the risk ranged from 1.6 to 2.1 for one lesion to 2.4-3.3 for ≥2. SC lesions increased the short-term disability risk around fivefold, better demonstrated in non-SC CIS. SC lesions were very specific for evolution to MS and showed very high sensitivity for EDSS ≥3.0. CONCLUSION: SC lesions are independent predictors of MS in all CIS and contribute to short-term disability accrual. SC MRIs in CIS could be useful to estimate their prognosis.
Authors: Andres G Barboza; Edgar Carnero Contentti; Maria Celeste Curbelo; Mario Javier Halfon; Juan Ignacio Rojas; Berenice A Silva; Vladimiro Sinay; Santiago Tizio; Maria Celica Ysrraelit; Ricardo Alonso Journal: Neurol Sci Date: 2021-01-25 Impact factor: 3.307
Authors: Elena Di Sabatino; Lorenzo Gaetani; Silvia Sperandei; Andrea Fiacca; Giorgio Guercini; Lucilla Parnetti; Massimiliano Di Filippo Journal: J Neurol Date: 2021-11-24 Impact factor: 4.849
Authors: Amy R McDowell; Natalia Petrova; Daniele Carassiti; Marc E Miquel; David L Thomas; Gareth J Barker; Klaus Schmierer; Tobias C Wood Journal: Magn Reson Med Date: 2022-01-11 Impact factor: 3.737