Early diffuse demyelinating lesion in the cervical spinal cord predicts a worse prognosis in relapsing—remitting multiple sclerosis
Objective: To study the long-term outcome and persistence of two patterns of cervical spinal cord abnormality in early relapsing—remitting multiple sclerosis (RRMS). Methods: RRMS patients with a spinal cord MRI performed during the first 3 years of the disease, a control MRI 5 years later and who h...
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| Veröffentlicht in: | Multiple sclerosis 2010-08, Vol.16 (8), p.935-941 |
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| creator | Coret, F. Bosca, I. Landete, L. Magraner, MJ Navarré, A. León, JL Casanova, B. |
| description | Objective: To study the long-term outcome and persistence of two patterns of cervical spinal cord abnormality in early relapsing—remitting multiple sclerosis (RRMS).
Methods: RRMS patients with a spinal cord MRI performed during the first 3 years of the disease, a control MRI 5 years later and who have been followed up at least 10 years were included. Patients were grouped according the T2 spinal cord MRI into: (A) nodular pattern, if one or more focal lesions were present; and (B) diffuse pattern, defined as a poorly demarcated high signal area. The end point was defined as the time to reach an Expanded Disability Status Score (EDSS) of 4.0.
Results: Twenty-five patients were included; 12 in group A and 13 in group B. Three patients in group A and 9 in group B reached EDSS 4, in a mean time of 11 years in group A and 7 years in group B (log rank 10.3, p = 0.001). Multivariate Cox regression analysis assessing the risk of EDSS 4.0 including sex, age, number of relapses in the first 2 years, number of T2 brain lesions and spinal cord pattern showed higher risk for the diffuse pattern (hazard ratio 7.2, 95% confidence interval 1.4—36.4). Control MRI showed the persistence of the diffuse pattern in all patients, and the development of diffuse pattern in two patients with basal nodular lesions.
Conclusions: The diffuse abnormality in cervical spinal cord at the beginning of the disease is persistent and predicts a worse prognosis in RRMS patients. |
| doi_str_mv | 10.1177/1352458510371960 |
| format | Article |
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Methods: RRMS patients with a spinal cord MRI performed during the first 3 years of the disease, a control MRI 5 years later and who have been followed up at least 10 years were included. Patients were grouped according the T2 spinal cord MRI into: (A) nodular pattern, if one or more focal lesions were present; and (B) diffuse pattern, defined as a poorly demarcated high signal area. The end point was defined as the time to reach an Expanded Disability Status Score (EDSS) of 4.0.
Results: Twenty-five patients were included; 12 in group A and 13 in group B. Three patients in group A and 9 in group B reached EDSS 4, in a mean time of 11 years in group A and 7 years in group B (log rank 10.3, p = 0.001). Multivariate Cox regression analysis assessing the risk of EDSS 4.0 including sex, age, number of relapses in the first 2 years, number of T2 brain lesions and spinal cord pattern showed higher risk for the diffuse pattern (hazard ratio 7.2, 95% confidence interval 1.4—36.4). Control MRI showed the persistence of the diffuse pattern in all patients, and the development of diffuse pattern in two patients with basal nodular lesions.
Conclusions: The diffuse abnormality in cervical spinal cord at the beginning of the disease is persistent and predicts a worse prognosis in RRMS patients.</description><identifier>ISSN: 1352-4585</identifier><identifier>EISSN: 1477-0970</identifier><identifier>DOI: 10.1177/1352458510371960</identifier><identifier>PMID: 20573640</identifier><identifier>CODEN: MUSCFZ</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Adult ; Biological and medical sciences ; Brain - pathology ; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases ; Female ; Humans ; Kaplan-Meier Estimate ; Longitudinal Studies ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Middle Aged ; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis ; Multiple Sclerosis, Relapsing-Remitting - pathology ; Multiple Sclerosis, Relapsing-Remitting - physiopathology ; Neurology ; Prognosis ; Proportional Hazards Models ; Spinal Cord - pathology ; Young Adult</subject><ispartof>Multiple sclerosis, 2010-08, Vol.16 (8), p.935-941</ispartof><rights>The Author(s) 2010</rights><rights>2015 INIST-CNRS</rights><rights>SAGE Publications © Aug 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c425t-5c24436bcbac6f867b6e9fa0ee1c9a61e29b7240b3607e3a6c5f8cfd4e1439df3</citedby><cites>FETCH-LOGICAL-c425t-5c24436bcbac6f867b6e9fa0ee1c9a61e29b7240b3607e3a6c5f8cfd4e1439df3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1352458510371960$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1352458510371960$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21818,27923,27924,43620,43621</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23164008$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20573640$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Coret, F.</creatorcontrib><creatorcontrib>Bosca, I.</creatorcontrib><creatorcontrib>Landete, L.</creatorcontrib><creatorcontrib>Magraner, MJ</creatorcontrib><creatorcontrib>Navarré, A.</creatorcontrib><creatorcontrib>León, JL</creatorcontrib><creatorcontrib>Casanova, B.</creatorcontrib><title>Early diffuse demyelinating lesion in the cervical spinal cord predicts a worse prognosis in relapsing—remitting multiple sclerosis</title><title>Multiple sclerosis</title><addtitle>Mult Scler</addtitle><description>Objective: To study the long-term outcome and persistence of two patterns of cervical spinal cord abnormality in early relapsing—remitting multiple sclerosis (RRMS).
Methods: RRMS patients with a spinal cord MRI performed during the first 3 years of the disease, a control MRI 5 years later and who have been followed up at least 10 years were included. Patients were grouped according the T2 spinal cord MRI into: (A) nodular pattern, if one or more focal lesions were present; and (B) diffuse pattern, defined as a poorly demarcated high signal area. The end point was defined as the time to reach an Expanded Disability Status Score (EDSS) of 4.0.
Results: Twenty-five patients were included; 12 in group A and 13 in group B. Three patients in group A and 9 in group B reached EDSS 4, in a mean time of 11 years in group A and 7 years in group B (log rank 10.3, p = 0.001). Multivariate Cox regression analysis assessing the risk of EDSS 4.0 including sex, age, number of relapses in the first 2 years, number of T2 brain lesions and spinal cord pattern showed higher risk for the diffuse pattern (hazard ratio 7.2, 95% confidence interval 1.4—36.4). Control MRI showed the persistence of the diffuse pattern in all patients, and the development of diffuse pattern in two patients with basal nodular lesions.
Conclusions: The diffuse abnormality in cervical spinal cord at the beginning of the disease is persistent and predicts a worse prognosis in RRMS patients.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Brain - pathology</subject><subject>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</subject><subject>Female</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Longitudinal Studies</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis</subject><subject>Multiple Sclerosis, Relapsing-Remitting - pathology</subject><subject>Multiple Sclerosis, Relapsing-Remitting - physiopathology</subject><subject>Neurology</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Spinal Cord - pathology</subject><subject>Young Adult</subject><issn>1352-4585</issn><issn>1477-0970</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkctq3TAQhkVpadKk-6yCKJSu3EjWzV6GkF4g0E27NrI8OlGQL9HYCWfXTd-gT9gnqZxz2kCgdKWB-f5fM_MTcsLZe86NOeNClVJVijNheK3ZM3LIpTEFqw17nuvcLtb-AXmFeMMYM0aol-SgZMoILdkh-XFpU9zSLni_INAO-i3EMNg5DBsaAcM40DDQ-Rqog3QXnI0UpwxE6sbU0SlBF9yM1NL7MWWHKY2bYcSAqyxBtBNmq1_ffybow_xg2y9xDlMEii5CWtlj8sLbiPB6_x6Rbx8uv158Kq6-fPx8cX5VOFmquVCulFLo1rXWaV9p02qovWUA3NVWcyjr1pSStUIzA8Jqp3zlfCeBS1F3XhyRdzvfPOXtAjg3fUAHMdoBxgUbo6Ra71L9n5RVLSopWSbfPCFvxiXlA2VISMONljxDbAe5vC8m8M2UQm_TtuGsWaNsnkaZJad736Xtofsr-JNdBt7uAYs5Fp_s4AI-coJn6mGVYseh3cDjcP_8-Dd8JrZV</recordid><startdate>20100801</startdate><enddate>20100801</enddate><creator>Coret, F.</creator><creator>Bosca, I.</creator><creator>Landete, L.</creator><creator>Magraner, MJ</creator><creator>Navarré, A.</creator><creator>León, JL</creator><creator>Casanova, B.</creator><general>SAGE Publications</general><general>Sage Publications</general><general>Sage Publications Ltd</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20100801</creationdate><title>Early diffuse demyelinating lesion in the cervical spinal cord predicts a worse prognosis in relapsing—remitting multiple sclerosis</title><author>Coret, F. ; Bosca, I. ; Landete, L. ; Magraner, MJ ; Navarré, A. ; León, JL ; Casanova, B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c425t-5c24436bcbac6f867b6e9fa0ee1c9a61e29b7240b3607e3a6c5f8cfd4e1439df3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Brain - pathology</topic><topic>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</topic><topic>Female</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Longitudinal Studies</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis</topic><topic>Multiple Sclerosis, Relapsing-Remitting - pathology</topic><topic>Multiple Sclerosis, Relapsing-Remitting - physiopathology</topic><topic>Neurology</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Spinal Cord - pathology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Coret, F.</creatorcontrib><creatorcontrib>Bosca, I.</creatorcontrib><creatorcontrib>Landete, L.</creatorcontrib><creatorcontrib>Magraner, MJ</creatorcontrib><creatorcontrib>Navarré, A.</creatorcontrib><creatorcontrib>León, JL</creatorcontrib><creatorcontrib>Casanova, B.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Multiple sclerosis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Coret, F.</au><au>Bosca, I.</au><au>Landete, L.</au><au>Magraner, MJ</au><au>Navarré, A.</au><au>León, JL</au><au>Casanova, B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early diffuse demyelinating lesion in the cervical spinal cord predicts a worse prognosis in relapsing—remitting multiple sclerosis</atitle><jtitle>Multiple sclerosis</jtitle><addtitle>Mult Scler</addtitle><date>2010-08-01</date><risdate>2010</risdate><volume>16</volume><issue>8</issue><spage>935</spage><epage>941</epage><pages>935-941</pages><issn>1352-4585</issn><eissn>1477-0970</eissn><coden>MUSCFZ</coden><abstract>Objective: To study the long-term outcome and persistence of two patterns of cervical spinal cord abnormality in early relapsing—remitting multiple sclerosis (RRMS).
Methods: RRMS patients with a spinal cord MRI performed during the first 3 years of the disease, a control MRI 5 years later and who have been followed up at least 10 years were included. Patients were grouped according the T2 spinal cord MRI into: (A) nodular pattern, if one or more focal lesions were present; and (B) diffuse pattern, defined as a poorly demarcated high signal area. The end point was defined as the time to reach an Expanded Disability Status Score (EDSS) of 4.0.
Results: Twenty-five patients were included; 12 in group A and 13 in group B. Three patients in group A and 9 in group B reached EDSS 4, in a mean time of 11 years in group A and 7 years in group B (log rank 10.3, p = 0.001). Multivariate Cox regression analysis assessing the risk of EDSS 4.0 including sex, age, number of relapses in the first 2 years, number of T2 brain lesions and spinal cord pattern showed higher risk for the diffuse pattern (hazard ratio 7.2, 95% confidence interval 1.4—36.4). Control MRI showed the persistence of the diffuse pattern in all patients, and the development of diffuse pattern in two patients with basal nodular lesions.
Conclusions: The diffuse abnormality in cervical spinal cord at the beginning of the disease is persistent and predicts a worse prognosis in RRMS patients.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>20573640</pmid><doi>10.1177/1352458510371960</doi><tpages>7</tpages></addata></record> |
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| ispartof | Multiple sclerosis, 2010-08, Vol.16 (8), p.935-941 |
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| subjects | Adult Biological and medical sciences Brain - pathology Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases Female Humans Kaplan-Meier Estimate Longitudinal Studies Magnetic Resonance Imaging Male Medical sciences Middle Aged Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis Multiple Sclerosis, Relapsing-Remitting - pathology Multiple Sclerosis, Relapsing-Remitting - physiopathology Neurology Prognosis Proportional Hazards Models Spinal Cord - pathology Young Adult |
| title | Early diffuse demyelinating lesion in the cervical spinal cord predicts a worse prognosis in relapsing—remitting multiple sclerosis |
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