Elena Di Sabatino1, Lorenzo Gaetani1, Silvia Sperandei1, Andrea Fiacca2, Giorgio Guercini2, Lucilla Parnetti1, Massimiliano Di Filippo3. 1. Section of Neurology, Department of Medicine and Surgery, University of Perugia, Santa Maria della Misericordia Hospital, Piazzale Menghini 1, 06132, Perugia, Italy. 2. Section of Neuroradiology, Santa Maria della Misericordia Hospital, Piazzale Menghini 1, 06132, Perugia, Italy. 3. Section of Neurology, Department of Medicine and Surgery, University of Perugia, Santa Maria della Misericordia Hospital, Piazzale Menghini 1, 06132, Perugia, Italy. massimiliano.difilippo@unipg.it.
Abstract
BACKGROUND: Measures to define treatment response, such as no evidence of disease activity (NEDA), are routinely used in multiple sclerosis (MS) clinical practice. Although spinal cord involvement is a frequent feature of MS, its magnetic resonance imaging (MRI) monitoring is not routinely performed. OBJECTIVE: To assess the impact of spinal cord MRI in the definition of NEDA in a cohort of people with MS (pwMS) with available spinal cord imaging performed as for routine monitoring. METHODS: We included 115 pwMS undergoing treatment with first-line disease-modifying therapies (DMTs) and retrospectively analyzed the presence of NEDA in the whole cohort, either considering or not spinal cord imaging. RESULTS: When considering only clinical and brain MRI measures, 97 out of 115 pwMS (84.3%) satisfied the criteria for NEDA. In the same cohort, the number of pwMS with NEDA significantly decreased to 88 (76.5%) (p < 0.01) when considering also spinal cord imaging. CONCLUSION: These findings suggest that, in routine clinical practice, spinal cord MRI monitoring in pwMS under first-line DMTs leads to a slight but significant change in the proportion of subjects classified as clinically and radiologically stable according to the NEDA definition.
BACKGROUND: Measures to define treatment response, such as no evidence of disease activity (NEDA), are routinely used in multiple sclerosis (MS) clinical practice. Although spinal cord involvement is a frequent feature of MS, its magnetic resonance imaging (MRI) monitoring is not routinely performed. OBJECTIVE: To assess the impact of spinal cord MRI in the definition of NEDA in a cohort of people with MS (pwMS) with available spinal cord imaging performed as for routine monitoring. METHODS: We included 115 pwMS undergoing treatment with first-line disease-modifying therapies (DMTs) and retrospectively analyzed the presence of NEDA in the whole cohort, either considering or not spinal cord imaging. RESULTS: When considering only clinical and brain MRI measures, 97 out of 115 pwMS (84.3%) satisfied the criteria for NEDA. In the same cohort, the number of pwMS with NEDA significantly decreased to 88 (76.5%) (p < 0.01) when considering also spinal cord imaging. CONCLUSION: These findings suggest that, in routine clinical practice, spinal cord MRI monitoring in pwMS under first-line DMTs leads to a slight but significant change in the proportion of subjects classified as clinically and radiologically stable according to the NEDA definition.
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