Spinal cord reserve in multiple sclerosis.

Jaume Sastre-Garriga, Alex Rovira, Aran García-Vidal, Pere Carbonell-Mirabent, Manel Alberich, Ángela Vidal-Jordana, Cristina Auger, Mar Tintore, X Montalban, Deborah Pareto

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Resum

Background The spinal cord (SC) is a preferential target of multiple sclerosis (MS) damage highly relevant towards disability. Differential impact of such damage could be due to the initial amount of SC tissue, as described for the brain parenchyma (brain reserve concept). We aimed to test the existence of SC reserve by using spinal canal area (SCaA) as a proxy.

Methods Brain sagittal three-dimensional T1-weighted scans covering down to C5 level were acquired in 2930 people with MS and 43 healthy controls (HCs) in a cross-sectional, multicentre study. SC area (SCA) and SCaA were obtained with the Spinal Cord Toolbox. Demographical data and patient-derived disability scores were obtained. SC parameters were compared between groups with age-adjusted and sex-adjusted linear regression models. The main outcome of the study, the existence of an association between SCaA and Patient Determined Disease Steps, was tested with scaled linear models.

Results 1747 persons with MS (mean age: 46.35 years; 73.2% female) and 42 HCs (mean age: 45.56 years; 78.6% female) were analysed after exclusion of post-processing errors and application of quality criteria. SCA (60.41 mm2 vs 65.02 mm2, p
Conclusions A larger SCaA may be protective against disability in MS, possibly supporting the existence of SC reserve.
Idioma originalEnglish
Número d’articlejnnp-2022-330613
Pàgines (de-a)502-510
Nombre de pàgines9
RevistaJournal of Neurology, Neurosurgery and Psychiatry
Volum94
Número7
Data online anticipada23 de gen. 2023
DOIs
Estat de la publicacióPublicada - 1 de jul. 2023

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