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Spinal Cord Volume Loss: Marker of MS Progression

Neurology; ePub 2018 Jun 27; Tsagkas, Magon, et al

Spinal cord volume (SCV) loss over time relates to the number of clinical relapses in relapsing-remitting multiple sclerosis (RRMS), but overall, does not differ between RRMS and secondary progressive MS (SPMS), a recent study found. SCV proved to be a strong predictor of physical disability and disease progression, indicating that it may be a suitable marker for monitoring disease activity and severity. Upper cervical SCV, total brain volume, and brain T2 lesion volume were measured annually in 231 patients with MS (180 RRMS and 51 SPMS) over 6 years on 3-dimensional, T1-weighted, magnetization-prepared rapid-acquisition gradient echo images. Expanded Disability Status Scale (EDSS) score and relapses were recorded at every follow-up. Researchers found:

  • Patients with SPMS had lower baseline SCV but no accelerated SCV loss compared to those with RRMS.
  • Clinical relapses were found to predict SCV loss over time in RRMS.
  • Furthermore, SCV loss, but not total brain volume and T2 lesion volume, was a strong predictor of EDSS score worsening over time.
  • Every 1% increase of the annual SCV loss rate was associated with an extra 28% risk increase of disease progression in the following year in both groups.


Tsagkas C, Magon S, Gaetano L, et al. Spinal cord volume loss. A marker of disease progression in multiple sclerosis. [Published online ahead of print June 27, 2018]. Neurology. doi:10.1212/WNL.0000000000005853

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