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Cervical lymph node diameter reflects disease progression in multiple sclerosis.

Anni Tuulasvaara1, Goran Kurdo2, Juha Martola2

  • 1Department of Neurology, Brain Center, Helsinki University Hospital, Helsinki, Finland; Department of Neurosciences, Clinicum, University of Helsinki, Helsinki, Finland.

Multiple Sclerosis and Related Disorders
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Deep cervical lymph node (CLN) diameter measured by MRI may indicate multiple sclerosis (MS) progression. Smaller CLN size correlated with increased disability, suggesting CLN diameter as a potential biomarker for MS disease activity.

Keywords:
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Area of Science:

  • Neurology
  • Immunology
  • Radiology

Background:

  • Multiple sclerosis (MS) is a central nervous system (CNS) autoimmune disease.
  • B cell activation in deep cervical lymph nodes (CLNs) precedes CNS migration.
  • CLN diameter in head MRI is an unexplored biomarker for MS disease activity.

Purpose of the Study:

  • To investigate the utility of CLN axial diameter as a biomarker for MS disease activity.
  • To evaluate the correlation between CLN diameter and clinical data in MS patients.

Main Methods:

  • Head MRIs were analyzed for CLN axial diameter in various MS patient groups (active stable RRMS, highly active stable RRMS, RRMS post-relapse, follow-up) and a control group.
  • Clinical data, including Expanded Disability Status Scale (EDSS) and disease duration, were collected.
  • Correlation and regression analyses were performed to assess relationships between CLN diameter and clinical parameters.

Main Results:

  • Smaller CLN diameter at imaging correlated with increased EDSS over a 2-year follow-up (r = -0.305, p = 0.009).
  • Enlarged CLNs (>10 mm) were more common in patients with shorter disease duration (p = 0.013).
  • CLN axial diameter was smaller in the RRMS-relapse group compared to controls (p = 0.005), and a decrease was observed during relapse.

Conclusions:

  • CLN diameter appears to reflect MS disease duration and progression.
  • A decrease in CLN diameter during relapse suggests dynamic changes in immune activity.
  • CLN axial diameter measured by MRI shows potential as a feasible biomarker for assessing MS disease activity.