Added value of spinal cord MRI in detecting active disease in non-relapsing progressive multiple sclerosis patients.

IF 4.8 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Neurology Pub Date : 2025-06-28 DOI:10.1007/s00415-025-13217-7

Marco Vercellino, S Marasciulo, C Bosa, A Rolando, P Garelli, M L Vassallo, V Gallina, G Morana, P Cavalla

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引用次数: 0

Abstract

Introduction: Spinal cord MRI is not routinely recommended in the monitoring of MS. In patients with progressive MS (pMS), presence of disease activity is an important predictor of treatment response to currently approved treatments. The aim of this study was to investigate the added usefulness of spinal cord MRI in the identification of active disease in patients with non-relapsing pMS.

Methods: MRI records were reviewed in a cohort of pMS patients. All patients with at least 2 years of follow-up with the same MRI scanner were included in the study. Patients with clinical relapses during follow-up were excluded from the study. Asymptomatic combined unique active lesions (CUA) were defined as any new T2/STIR lesion or any T1 Gd + lesion, in absence of a clinical relapse.

Results: 185 non-relapsing pMS patients were included in the study (41 primary progressive, 144 secondary progressive; median EDSS 6.0), out of a cohort of 422 pMS patients. Mean length of MRI follow-up was 4.0 years (range 2-8). 28/185 (15.1%) patients showed new asymptomatic CUA brain lesions during follow-up, 14/185 (7.6%) patients showed new asymptomatic CUA spinal cord lesions, 4/185 (3.4%) patients showed new asymptomatic CUA lesions both in the brain and in the spinal cord. Overall, the addition of spinal cord MRI allowed to detect disease activity in + 43.75% more patients than brain MRI only.

Conclusion: The addition of spinal cord MRI allows to detect active disease in a significantly higher proportion of non-relapsing pMS patients. This is important in stratifying expected response to treatment and to inform treatment choices.

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脊髓MRI对非复发进行性多发性硬化症患者活动性病变的检测价值。

在进行性多发性硬化症（pMS）患者中，疾病活动的存在是对目前批准的治疗反应的重要预测指标。本研究的目的是探讨脊髓MRI在鉴别非复发性经前综合征患者的活动性疾病方面的额外用处。方法：回顾一组经前症候群患者的MRI记录。所有接受相同MRI扫描仪随访至少2年的患者均被纳入研究。随访期间出现临床复发的患者排除在研究之外。无症状合并独特活动性病变（CUA）定义为任何新的T2/STIR病变或任何T1 Gd +病变，没有临床复发。结果：185例非复发性经前综合征患者纳入研究(41例原发性进展性，144例继发性进展性；中位EDSS 6.0)，来自422名经前症候群患者。MRI随访时间平均为4.0年（范围2-8年）。随访期间，28/185（15.1%）患者出现新的无症状CUA脑病变，14/185（7.6%）患者出现新的无症状CUA脊髓病变，4/185（3.4%）患者出现新的无症状CUA脑和脊髓病变。总体而言，与仅使用脑MRI相比，添加脊髓MRI可以多检测43.75%的患者的疾病活动。结论：在非复发性经前症候群患者中，脊髓MRI的增加可以显著提高发现活动性疾病的比例。这对于对治疗的预期反应进行分层和告知治疗选择是很重要的。

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.