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Updated: Apr 1, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Relevance of asymptomatic spinal MRI lesions in patients with multiple sclerosis
C Zecca1, G Disanto1, M P Sormani2
1Multiple Sclerosis Center, Neurocenter of Southern Switzerland, Ospedale Regionale di Lugano, Switzerland.
Background:
The impact of new asymptomatic spinal cord lesions (a-SL) in multiple sclerosis (MS) course is poorly characterized.
Objective:
The objective of this research paper is to assess the prognostic value of a-SL in predicting MS course.
Methods:
Relapsing-remitting MS patients who received serial MRI (brain and spinal) at baseline (t1) and within 12 to 36 months (t2) during clinical stability, and had a follow-up (t2-t3) ⩾24 months were included. Relapses and disability progression were evaluated between t2 and t3.
Results:
Of 413 consecutive screened MS patients, 103 patients (65 females, median age 43 years) were included. After a median t1-t2 interval of 17 (IQR 13-26) months, 25.2% and 43.7% patients had ⩾1 new a-SL (a-SL+) and asymptomatic brain lesions (a-BL+), respectively. Relapse risk between t2 and t3 (median interval: 42 (IQR 32-57.5) months) was significantly increased in a-SL+ and/or a-BL+ vs a-BL- and a-SL- (HR = 2.31, 95% CI = 1.13-4.72, p = 0.02). No differences in the risk of disability progression were found in a-SL+ and/or a-BL+ vs a-SL- and a-BL-.
Conclusion:
a-SL occur in one-quarter of clinically stable RRMS, and combined with a-BL contribute significantly in predicting future disease course.
Insights
New asymptomatic spinal cord lesions (a-SL) in multiple sclerosis (MS) predict future relapses. These lesions, along with asymptomatic brain lesions (a-BL), are important indicators of MS disease activity.
Area of Science:
- Neurology
- Radiology
- Immunology
Background:
- The prognostic significance of new asymptomatic spinal cord lesions (a-SL) in multiple sclerosis (MS) remains unclear.
- Understanding lesion impact is crucial for predicting MS disease course.
Purpose of the Study:
- To evaluate the predictive value of a-SL for the future course of MS.
- To assess the combined impact of spinal and brain lesions on MS progression.
Main Methods:
- Included 103 relapsing-remitting MS patients with serial MRI scans (brain and spinal) over a median of 17 months.
- Assessed relapses and disability progression over a median follow-up of 42 months post-second MRI.
- Analyzed new asymptomatic spinal cord lesions (a-SL) and asymptomatic brain lesions (a-BL).
Main Results:
- 25.2% of patients developed new a-SL, and 43.7% developed new a-BL.
- Patients with a-SL and/or a-BL showed a significantly increased risk of relapse (HR=2.31).
- No significant difference in disability progression risk was observed between groups.
Conclusions:
- Asymptomatic spinal cord lesions are present in a quarter of clinically stable RRMS patients.
- The presence of a-SL, particularly when combined with a-BL, significantly aids in predicting future MS disease activity.
- a-SL are valuable biomarkers for MS prognosis.
