Cervical Cord Atrophy and Long-Term Disease Progression in Patients with Primary-Progressive Multiple Sclerosis

Area of Science:

• Neuroimaging
• Neurology
• Clinical research

Background:

• Cervical cord atrophy is linked to clinical disability in multiple sclerosis (MS).
• It is considered a potential outcome measure for neurodegeneration in MS.
• Primary-progressive MS (PPMS) is characterized by continuous neurological decline.

Purpose of the Study:

• To quantify cervical cord atrophy development in PPMS patients.
• To assess the association between cervical cord atrophy and disability progression in PPMS.
• To evaluate the predictive value of cervical cord atrophy for long-term disability.

Main Methods:

• MR imaging of the brain and spinal cord was performed on 31 PPMS patients at baseline and 6-7 years later.
• Cervical spinal cord segmentation (C1-C5) was used to measure cross-sectional areas.
• Clinical progression was assessed using the Expanded Disability Status Scale (EDSS) over 14 years.

Main Results:

• Moderate correlations were observed between normalized cross-sectional area measurements and the EDSS area under the curve.
• The annualized rate of normalized mean cross-sectional area loss independently predicted long-term disability.
• Baseline EDSS score also emerged as an independent predictor of long-term disability progression.

Conclusions:

• Cervical cord atrophy development is associated with disability progression in PPMS.
• Cervical cord atrophy is a predictive marker for disability progression in PPMS.
• These findings support cervical cord atrophy as a valuable outcome measure in PPMS research.