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Infratentorial and spinal cord lesions: Cumulative predictors of long-term disability?

Iris Dekker1, Madeleine H Sombekke2, Lisanne J Balk2

  • 1Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands/Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|August 3, 2019
PubMed
Abstract

Insights

Early spinal cord lesions in multiple sclerosis (MS) significantly predict long-term disability progression. However, the combined presence of spinal cord and infratentorial lesions did not show a greater risk for MS progression.

Area of Science:

  • Neurology
  • Neuroimmunology
  • Clinical Neuroscience

Background:

  • Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
  • Disability progression in MS is a key concern for patients and clinicians.
  • Identifying early predictors of MS progression is crucial for timely intervention.

Purpose of the Study:

  • To investigate whether early infratentorial and spinal cord lesions predict long-term disability progression in multiple sclerosis.
  • To compare the risk of disability progression in patients with isolated vs. combined infratentorial and spinal cord lesions.

Main Methods:

  • Analysis of 153 patients from the longitudinal Amsterdam MS cohort.
  • Lesion assessment at baseline and year 2.
  • Disability measured using Expanded Disability Status Scale (EDSS) and EDSS-plus at 6 and 11 years.

Main Results:

  • Baseline spinal cord lesions were associated with a significantly higher risk of 6-year EDSS and EDSS-plus progression.
  • Spinal cord lesions also predicted an increased risk of 11-year EDSS progression.
  • Patients with both infratentorial and spinal cord lesions did not exhibit a higher risk of disability progression compared to those with lesions in only one location.

Conclusions:

  • Early spinal cord lesions appear to be a dominant risk factor for disability progression in multiple sclerosis.
  • The simultaneous presence of early infratentorial and spinal cord lesions did not unequivocally predict greater disability progression.
Keywords:
Multiple sclerosisdisability progressioninfratentorialspinal cord

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