Cervical spinal cord gray matter damage predicts disability worsening in multiple sclerosis: a longitudinal study.

IF 4.8 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Neurology Pub Date : 2025-02-25 DOI:10.1007/s00415-025-12979-4

Matteo Azzimonti, Paolo Preziosa, Elisabetta Pagani, Alessandro Meani, Monica Margoni, Martina Rubin, Mor Gueye, Federica Esposito, Massimo Filippi, Maria A Rocca

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引用次数: 0

Abstract

Objective: Cervical spinal cord (cSC) gray matter (GM) damage is associated with current disability in multiple sclerosis (MS), but its prognostic value remains unexplored. We aimed to investigate whether cSC GM damage may predict disability worsening in MS.

Materials and methods: Seventy-nine MS patients and 49 healthy controls (HC) underwent 3 T brain and cSC MRI at baseline and two neurological evaluations after median follow-up of 1.3 years. Total and GM cSC lesions were identified on axial T2-weighted sequences, whereas global and GM cSC cross-sectional areas (CSAs) at C3-C4 level were quantified on phase-sensitive inversion recovery sequences. Brain lesional and volumetric measures were also assessed. At follow-up, disability worsening was defined as deterioration on ≥ 1/3 components of the Expanded Disability Status Scale (EDSS)-plus score (EDSS worsening or ≥ 20% change in timed 25-foot walk [T25FWT] or 9-hole peg test [9-HPT]).

Results: At follow-up, 40/79 (50.6%) patients showed EDSS-plus worsening, with 13/79 (16.4%) worsening at EDSS score, 13/79 (16.4%) at 9-HPT, and 29/79 (36.7%) at T25FWT. Progressive phenotype (odds ratio [OR] = 8.65) predicted EDSS worsening (p = 0.001, C-index = 0.79). Progressive phenotype (OR = 5.56), lower cortical volume (OR = 0.41), and higher cSC GM T2-hyperintense lesion volume (OR = 2.28) (p ≤ 0.035, C-index = 0.88) predicted 9-HPT worsening. Longer disease duration (OR = 1.64), progressive phenotype (OR = 4.74), and lower cSC GM CSA (OR = 0.51) predicted T25FWT worsening (p ≤ 0.050, C-index = 0.77). Male sex (OR = 6.12), older age (OR = 1.71), progressive phenotype (OR = 7.40), and lower cSC GM CSA (OR = 0.47) predicted EDSS-plus worsening (p ≤ 0.055, C-index = 0.83).

Conclusions: cSC GM damage emerged as a relevant MRI predictor of disability worsening in MS, highlighting its prognostic relevance.

查看原文本刊更多论文

颈脊髓灰质损伤预测多发性硬化症残疾恶化：一项纵向研究。

目的：颈脊髓（cSC）灰质（GM）损伤与多发性硬化症（MS）患者当前的残疾有关，但其预后价值仍未探明。我们的目的是研究cSC GM损伤是否可以预测MS的残疾恶化。材料和方法：79名MS患者和49名健康对照（HC）在基线时接受了3次T脑和cSC MRI，并在中位随访1.3年后进行了两次神经学评估。轴向t2加权序列确定了总cSC和GM cSC病变，而相位敏感反转恢复序列量化了C3-C4水平的全局和GM cSC横截面积（csa）。脑损伤和体积测量也进行了评估。随访时，残疾恶化被定义为扩展残疾状态量表(EDSS) +评分≥1/3分量的恶化（EDSS恶化或25英尺步行时间[T25FWT]或9孔peg试验[9-HPT]变化≥20%）。结果：随访时，40/79（50.6%）患者出现EDSS加重，其中13/79（16.4%）患者在EDSS评分加重，13/79（16.4%）患者在9-HPT评分加重，29/79（36.7%）患者在T25FWT评分加重。进行性表型（比值比[OR] = 8.65）预测EDSS恶化（p = 0.001, C-index = 0.79）。进行性表型（OR = 5.56）、皮质体积减小（OR = 0.41）、cSC GM t2高病变体积增大（OR = 2.28）（p≤0.035,C-index = 0.88）预测9-HPT恶化。病程较长（OR = 1.64）、表型渐进性（OR = 4.74）和cSC GM CSA较低（OR = 0.51）预测T25FWT恶化（p≤0.050,C-index = 0.77）。男性（OR = 6.12）、年龄较大（OR = 1.71）、进行性表型（OR = 7.40）和cSC GM CSA较低（OR = 0.47）预测EDSS-plus恶化（p≤0.055,C-index = 0.83）。结论：cSC GM损伤是MS残疾恶化的相关MRI预测指标，突出了其预后相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neurology 医学-临床神经学

CiteScore

10.00

自引率

5.00%

发文量

558

审稿时长

1 months

期刊介绍： The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field. In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials. Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.