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BMC Neurology
Published in: BMC Neurology 1/2022

Open Access 01-12-2022 | Magnetic Resonance Imaging | Research article

Brainstem lesions are associated with diffuse spinal cord involvement in early multiple sclerosis

Authors: Michaela Andelova, Karolina Vodehnalova, Jan Krasensky, Eliska Hardubejova, Tereza Hrnciarova, Barbora Srpova, Tomas Uher, Ingrid Menkyova, Dominika Stastna, Lucie Friedova, Jiri Motyl, Jana Lizrova Preiningerova, Eva Kubala Havrdova, Bénédicte Maréchal, Mário João Fartaria, Tobias Kober, Dana Horakova, Manuela Vaneckova

Published in: BMC Neurology | Issue 1/2022

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Abstract

Background

Early infratentorial and focal spinal cord lesions on magnetic resonance imaging (MRI) are associated with a higher risk of long-term disability in patients with multiple sclerosis (MS). The role of diffuse spinal cord lesions remains less understood. The purpose of this study was to evaluate focal and especially diffuse spinal cord lesions in patients with early relapsing-remitting MS and their association with intracranial lesion topography, global and regional brain volume, and spinal cord volume.

Methods

We investigated 58 MS patients with short disease duration (< 5 years) from a large academic MS center and 58 healthy controls matched for age and sex. Brain, spinal cord, and intracranial lesion volumes were compared among patients with- and without diffuse spinal cord lesions and controls. Binary logistic regression models were used to analyse the association between the volume and topology of intracranial lesions and the presence of focal and diffuse spinal cord lesions.

Results

We found spinal cord involvement in 75% of the patients (43/58), including diffuse changes in 41.4% (24/58). Patients with diffuse spinal cord changes exhibited higher volumes of brainstem lesion volume (p = 0.008). The presence of at least one brainstem lesion was associated with a higher probability of the presence of diffuse spinal cord lesions (odds ratio 47.1; 95% confidence interval 6.9–321.6 p < 0.001) as opposed to focal spinal cord lesions (odds ratio 0.22; p = 0.320). Patients with diffuse spinal cord lesions had a lower thalamus volume compared to patients without diffuse spinal cord lesions (p = 0.007) or healthy controls (p = 0.002).

Conclusions

Diffuse spinal cord lesions are associated with the presence of brainstem lesions and with a lower volume of the thalamus. This association was not found in patients with focal spinal cord lesions. If confirmed, thalamic atrophy in patients with diffuse lesions could increase our knowledge on the worse prognosis in patients with infratentorial and SC lesions.
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Metadata
Title
Brainstem lesions are associated with diffuse spinal cord involvement in early multiple sclerosis
Authors
Michaela Andelova
Karolina Vodehnalova
Jan Krasensky
Eliska Hardubejova
Tereza Hrnciarova
Barbora Srpova
Tomas Uher
Ingrid Menkyova
Dominika Stastna
Lucie Friedova
Jiri Motyl
Jana Lizrova Preiningerova
Eva Kubala Havrdova
Bénédicte Maréchal
Mário João Fartaria
Tobias Kober
Dana Horakova
Manuela Vaneckova
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2022
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-022-02778-z

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