Presence of brainstem lesions is associated with diffuse spinal cord abnormalities in patients with early multiple sclerosis
Abstract
The presence of early spinal cord (SC) and infratentorial lesions has been associated with higher risk of long-term disability in multiple sclerosis (MS). Little is known about significance of early diffuse SC abnormalities.
We aimed to examine the association of intracranial lesion distribution and SC pathology in patients with early-stage MS (PweMS; disease duration <=5 years). The presence of early spinal cord (SC) and infratentorial lesions has been associated with higher risk of long-term disability in multiple sclerosis (MS).
Little is known about significance of early diffuse SC abnormalities. We aimed to examine the association of intracranial lesion distribution and SC pathology in patients with early-stage MS (PweMS; disease duration <=5 years). with ScanView.
Diffuse SC pathology was estimated by 2 raters on T2WFS/PDW images. Volume and lesion parameters of PweMS with- and without diffuse SC abnormalities were compared by (non)parametric tests.
Risk of having diffuse SC abnormalities was determined by logistic regression.Results: Table 1 summarizes the results. PweMS with diffuse SC abnormalities had higher brainstem and cerebellar LV than PweMS without (p=0.007 and p=0.024), whereas they did not differ in total intracranial LV (p=0.249), brain- and SC-volume (p=0.975, p=0.716).
Early brainstem lesions showed a 6-fold increased risk of diffuse SC abnormalities (OR 6.04, 95% CI 1.56-23.39, p=0.009).Conclusion: Early brainstem lesions are associated with higher risk of SC diffuse abnormalities, that are not associated with relative SC volume loss. Early diffuse SC abnormalities might therefore i.) precede spinal cord atrophy and ii.) present a link between infratentorial lesions and risk of long-term disability.