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Clinically relevant cranio-caudal patterns of cervical cord atrophy evolution in MS

Rocca, Maria A ; Valsasina, Paola ; Meani, Alessandro ; Gobbi, Claudio ; Zecca, Chiara ; Rovira, Àlex ; Montalban, Xavier ; Kearney, Hugh ; Ciccarelli, Olga ; Matthews, Lucy ; Palace, Jacqueline ; Gallo, Antonio ; Bisecco, Alvino ; Gass, Achim ; Eisele, Philipp ; Lukas, Carsten ; Bellenberg, Barbara ; Barkhof, Frederik ; Vrenken, Hugo ; Preziosa, Paolo ; Comi, Giancarlo ; Filippi, Massimo

Neurology, 2019-11, Vol.93 (20), p.e1852-e1866 [Periódico revisado por pares]

United States: American Academy of Neurology

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Título:
Clinically relevant cranio-caudal patterns of cervical cord atrophy evolution in MS
Autor: Rocca, Maria A ; Valsasina, Paola ; Meani, Alessandro ; Gobbi, Claudio ; Zecca, Chiara ; Rovira, Àlex ; Montalban, Xavier ; Kearney, Hugh ; Ciccarelli, Olga ; Matthews, Lucy ; Palace, Jacqueline ; Gallo, Antonio ; Bisecco, Alvino ; Gass, Achim ; Eisele, Philipp ; Lukas, Carsten ; Bellenberg, Barbara ; Barkhof, Frederik ; Vrenken, Hugo ; Preziosa, Paolo ; Comi, Giancarlo ; Filippi, Massimo
Assuntos: Adolescent ; Adult ; Aged ; Atrophy ; Cervical Vertebrae ; Demyelinating Diseases - diagnostic imaging ; Demyelinating Diseases - pathology ; Demyelinating Diseases - physiopathology ; Disease Progression ; Female ; Humans ; Longitudinal Studies ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Multiple Sclerosis - diagnostic imaging ; Multiple Sclerosis - pathology ; Multiple Sclerosis - physiopathology ; Multiple Sclerosis, Chronic Progressive - diagnostic imaging ; Multiple Sclerosis, Chronic Progressive - pathology ; Multiple Sclerosis, Chronic Progressive - physiopathology ; Multiple Sclerosis, Relapsing-Remitting - diagnostic imaging ; Multiple Sclerosis, Relapsing-Remitting - pathology ; Multiple Sclerosis, Relapsing-Remitting - physiopathology ; Spinal Cord - diagnostic imaging ; Spinal Cord - pathology ; Young Adult
É parte de: Neurology, 2019-11, Vol.93 (20), p.e1852-e1866
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SourceType-Scholarly Journals-1
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Descrição: OBJECTIVETo characterize the distribution and regional evolution of cervical cord atrophy in patients with multiple sclerosis (MS) in a multicenter dataset. METHODSMRI and clinical evaluations were acquired from 179 controls and 435 patients (35 clinically isolated syndromes [CIS], 259 relapsing-remitting multiple sclerosis [RRMS], 99 secondary progressive multiple sclerosis [SPMS], and 42 primary progressive multiple sclerosis [PPMS]). Sixty-nine controls and 178 patients underwent a 1-year MRI and clinical follow-up. Patients were classified as clinically stable/worsened according to their disability change. Longitudinal changes of cord atrophy were investigated with linear mixed-effect models. Sample size calculations were performed using age-, sex- and site-adjusted annualized percentage normalized cord cross-sectional area (CSAn) changes. RESULTSBaseline CSAn was lower in patients with MS vs controls (p < 0.001), but not different between controls and patients with CIS or between patients with early RRMS (disease duration ≤5 years) and patients with CIS. Patients with late RRMS (disease duration >5 years) showed significant cord atrophy vs patients with early RRMS (p = 0.02). Patients with progressive MS had decreased CSAn (p < 0.001) vs patients with RRMS. Atrophy was located between C1/C2 and C5 in patients with RRMS vs patients with CIS, and widespread along the cord in patients with progressive MS vs patients with RRMS, with an additional C5/C6 involvement in patients with SPMS vs patients with PPMS. At follow-up, CSAn decreased in all phenotypes (p < 0.001), except CIS. Cord atrophy rates were highest in patients with early RRMS and clinically worsened patients, who had a more widespread cord involvement than stable patients. The sample size per arm required to detect a 50% treatment effect was 118 for patients with early RRMS. CONCLUSIONSCord atrophy increased in MS during 1 year, except for CIS. Faster atrophy contributed to explain clinical worsening.
Editor: United States: American Academy of Neurology
Idioma: Inglês

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Clinically relevant cranio-caudal patterns of cervical cord atrophy evolution in MS

United States: American Academy of Neurology

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