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Radiological Disease Activity in Secondary Progressive Multiple Sclerosis
Daniela Noa Zohar1,2,3, David Magalashvili1, Sapir Dreyer-Alster1,4
1Multiple Sclerosis Center, Sheba Medical Center, Ramat-Gan, Israel.
Introduction:
MRI activity is less frequent among secondary progressive multiple sclerosis (SPMS) patients. In the current study, we aimed to identify SPMS patients with higher radiological disease activity (RDA) and determine their clinical characteristics.
Methods:
We evaluated the occurrence of RDA in SPMS patients followed at the Sheba Multiple Sclerosis Center between January 1, 2015, and December 31, 2020. All patients underwent brain and spinal cord MRI examinations as a routine follow-up unrelated to clinical disease activity. Patients were subdivided into RDA and non-RDA MRI groups based on the presence of active gadolinium-enhancing T1 lesions and/or new/enlarging T2 lesions. Demographic variables and disease-related data were compared.
Results:
One hundred consecutive SPMS patients, 74 females, median age of 50 years, disease duration of 19.5 years, and neurological disability by the Expanded Disability Status Scale (EDSS) score of 6.0, were included in the study. The RDA group comprised 35 patients (35%), of them 65.7% (n = 23) exhibited only brain MRI activity, 22.8% (n = 8) only spinal cord MRI activity, and 11.4% (n = 4) had both. Patients in the RDA group were diagnosed at a younger mean (SD) age of 28.2 (8.9) versus 33.7 (10.1) years and were younger with a mean (SD) age of 47.8 (9.9) versus 53.4 (10.1) years, as compared with the non-RDA group. No significant differences were found in relation to disease duration, EDSS, exposure to immunomodulatory treatments, and duration of immunomodulatory treatments.
Conclusions:
RDA unrelated to clinical symptomatology was more frequent in a subgroup of young SPMS patients.
Insights
Radiological disease activity (RDA) was observed in 35% of secondary progressive multiple sclerosis (SPMS) patients, particularly in younger individuals. This activity often occurred without new clinical symptoms, highlighting the need for regular MRI monitoring in this demographic.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Secondary progressive multiple sclerosis (SPMS) typically shows reduced MRI activity.
- Identifying SPMS patients with active radiological disease is crucial for understanding disease progression.
Purpose of the Study:
- To identify SPMS patients exhibiting higher radiological disease activity (RDA).
- To determine the clinical characteristics associated with RDA in SPMS patients.
Main Methods:
- Retrospective evaluation of 100 SPMS patients from 2015-2020.
- Classification into RDA and non-RDA groups based on MRI findings (active gadolinium-enhancing T1 lesions and/or new/enlarging T2 lesions).
- Comparison of demographic and disease-related data between groups.
Main Results:
- 35% of SPMS patients (n=35) showed RDA.
- RDA patients were diagnosed and were younger at the time of the study compared to non-RDA patients.
- No significant differences in disease duration, EDSS, or immunomodulatory treatment exposure were found.
Conclusions:
- Radiological disease activity is more frequent in younger SPMS patients.
- RDA can occur in SPMS patients even without apparent clinical symptoms.
- Younger age at diagnosis and current age are associated with higher RDA in SPMS.
