Association of asymptomatic spinal cord lesions and atrophy with disability 5 years after a clinically isolated syndrome

被引:104
作者
Brownlee, W. J. [1 ]
Altmann, D. R. [1 ,2 ]
Da Mota, P. Alves [1 ]
Swanton, J. K. [1 ]
Miszkiel, K. A. [3 ]
Wheeler-Kingshott, C. A. M. Gandini [1 ,4 ]
Ciccarelli, O. [1 ,5 ]
Miller, D. H. [1 ,5 ]
机构
[1] UCL Inst Neurol, Queen Sq Multiple Sclerosis Ctr, Dept Neuroinflammat, Box 112, London WC1N 3BG, England
[2] London Sch Hyg & Trop Med, Dept Med Stat, London, England
[3] Natl Hosp Neurol & Neurosurg, Lysholm Dept Neuroradiol, London, England
[4] C Mondino Natl Neurol Inst, Connect Ctr, Pavia, Italy
[5] NIHR Univ Coll London Hosp, Biomed Res Ctr, London, England
关键词
Clinically isolated syndrome; multiple sclerosis; MRI; spinal cord; MULTIPLE-SCLEROSIS; CERVICAL CORD; OPTIC NEURITIS; BRAIN-STEM; MRI; MS; ABNORMALITIES; PROGRESSION; IMPAIRMENT; GUIDELINES;
D O I
10.1177/1352458516663034
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Spinal cord pathology is an important substrate for long-term disability in multiple sclerosis (MS). Objective: To investigate longitudinal changes in spinal cord lesions and atrophy in patients with a non spinal clinically isolated syndrome (CIS), and how they relate to the development of disability. Methods: In all, 131 patients with a non-spinal CIS had brain and spinal cord imaging at the time of CIS and approximately 5 years later (median: 5.2 years, range: 3.0-7.9 years). Brain magnetic resonance imaging (MRI) measures consisted of T2-hyperintense and T1-hypointense lesion loads plus brain atrophy. Spinal cord MRI measures consisted of lesion number and the upper cervical cord cross-sectional area (UCCA). Disability was measured using the Expanded Disability Status Scale (EDSS). Multiple linear regression was used to identify independent predictors of disability after 5 years. Results: During follow-up, 93 (71%) patients were diagnosed with MS. Baseline spinal cord lesion number, change in cord lesion number and change in UCCA were independently associated with EDSS (R-2=0.53) at follow-up. Including brain T2 lesion load and brain atrophy only modestly increased the predictive power of the model (R-2=0.64). Conclusion: Asymptomatic spinal cord lesions and spinal cord atrophy contribute to the development of MS-related disability over the first 5 years after a non-spinal CIS.
引用
收藏
页码:665 / 674
页数:10
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