Brainstem lesions are associated with diffuse spinal cord involvement in early multiple sclerosis.

Area of Science:

• Neurology
• Radiology
• Neuroimmunology

Background:

• Spinal cord lesions on MRI impact multiple sclerosis (MS) disability.
• The role of diffuse spinal cord lesions in MS is not well understood.
• Early infratentorial and focal spinal cord lesions correlate with higher MS disability risk.

Purpose of the Study:

• Evaluate focal and diffuse spinal cord lesions in early relapsing-remitting MS.
• Assess associations with intracranial lesion topography.
• Determine relationships with global and regional brain/spinal cord volumes.

Main Methods:

• Investigated 58 MS patients (disease duration <5 years) and 58 controls.
• Compared brain, spinal cord, and intracranial lesion volumes.
• Used logistic regression to analyze lesion associations.

Main Results:

• Spinal cord involvement found in 75% of MS patients; diffuse changes in 41.4%.
• Diffuse spinal cord lesions associated with higher brainstem lesion volume (p=0.008).
• Diffuse lesions linked to lower thalamus volume compared to controls (p=0.002).

Conclusions:

• Diffuse spinal cord lesions correlate with brainstem lesions and reduced thalamus volume in MS.
• This association was not observed with focal spinal cord lesions.
• Thalamic atrophy in diffuse lesions may indicate worse MS prognosis.