Critical spinal cord lesions associate with secondary progressive motor impairment in long-standing MS: A population-based case-control study

Background: Progressive motor impairment anatomically attributable to prominent, focally atrophic lateral column spinal cord lesions (“critical lesions”) can be seen in multiple sclerosis (MS), for example, progressive hemiparetic MS. Objective: The aim of this study was to investigate whether simil...

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Bibliographic Details
Published in:Multiple sclerosis 2021-04, Vol.27 (5), p.667-673
Main Authors: Sechi, Elia, Messina, Steven, Keegan, B Mark, Buciuc, Marina, Pittock, Sean J, Kantarci, Orhun H, Weinshenker, Brian G, Flanagan, Eoin P
Format: Article
Language:English
Subjects:
Case-Control Studies
Demyelination
Disease Progression
Humans
Lesions
Magnetic Resonance Imaging
Motor Disorders
Motor task performance
Multiple Sclerosis
Multiple Sclerosis, Chronic Progressive - diagnostic imaging
Multiple Sclerosis, Relapsing-Remitting - diagnostic imaging
Multivariate analysis
Neuroimaging
Population studies
Population-based studies
Retrospective Studies
Spinal Cord
Spine
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Summary:Background: Progressive motor impairment anatomically attributable to prominent, focally atrophic lateral column spinal cord lesions (“critical lesions”) can be seen in multiple sclerosis (MS), for example, progressive hemiparetic MS. Objective: The aim of this study was to investigate whether similar spinal cord lesions are more frequent in long-standing MS patients with secondary progressive motor impairment (secondary progressive MS (SPMS)) versus those maintaining a relapsing-remitting course (relapsing-remitting MS (RRMS)). Methods: We retrospectively identified Olmsted County (MN, USA) residents on 31 December 2011 with (1) RRMS or SPMS for ⩾25 years, and (2) available brain and spine magnetic resonance imaging (MRI). A blinded neuroradiologist determined demyelinating lesion burden and presence of potential critical lesions (prominent focally atrophic spinal cord lateral column lesions). Results: In total, 32 patients were included: RRMS, 18; SPMS, 14. Median (range) disease duration (34 (27–53) vs. 39 (29–47) years) and relapse number (4 (1–10) vs. 3 (1–15)) were similar. In comparison to RRMS, SPMS patients more commonly showed potential critical spinal cord lesions (8/18 (44%) vs. 14/14 (100%)), higher spinal cord (median (range) 4 (1–7) vs. 7.5 (3–12)), and brain infratentorial (median (range) 1 (0–12) vs. 2.5 (1–13)) lesion number; p 
ISSN:1352-4585
1477-0970
DOI:10.1177/1352458520929192