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Cord atrophy separates early primary progressive and relapsing remitting multiple sclerosis.
M Bieniek1, D R Altmann, G R Davies
1NMR Research Unit, Institute of Neurology, University College London, London, UK.
Journal of Neurology, Neurosurgery, and Psychiatry
|June 24, 2006
Summary
Spinal cord atrophy, not brain abnormalities, distinguishes early primary progressive multiple sclerosis (PPMS) from relapsing-remitting MS (RRMS). This finding highlights cord atrophy as a key marker for PPMS progression and therapeutic trials.
Area of Science:
- Neuroimaging
- Neurology
- Multiple Sclerosis Research
Background:
- Multiple sclerosis (MS) presents as relapsing-remitting (RRMS) or primary progressive (PPMS) forms.
- Understanding early progressive disability in PPMS is crucial for identifying therapeutic targets.
Purpose of the Study:
- To investigate magnetic resonance imaging (MRI) parameters associated with early progressive disability in PPMS.
- To differentiate early PPMS from early RRMS using MRI metrics.
Main Methods:
- Compared five MRI parameters (brain atrophy, grey matter/white matter MTR, spinal cord atrophy) in 43 early PPMS patients, 37 early RRMS patients, and controls.
- Utilized multivariate analysis including age and sex.
Main Results:
- PPMS patients were older and more frequently male.
- Both PPMS and RRMS groups showed brain grey/white matter atrophy and MTR abnormalities.
- Spinal cord atrophy was significantly present only in the PPMS group.
Conclusions:
- Brain grey and white matter abnormalities are common in both early RRMS and PPMS.
- Spinal cord atrophy is a distinguishing feature of early PPMS, correlating with myelopathy.
- Measuring spinal cord atrophy is clinically relevant for PPMS treatment trials.