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Spinal Cord. 2015 Jul;53(7):520-5. doi: 10.1038/sc.2014.238. Epub 2015 Jan 13.

Thoracic spinal cord lesions are influenced by the degree of cervical spine involvement in multiple sclerosis.

Author information

1
Lou Ruvo Center for Brain Health, Cleveland Clinic, Las Vegas, NV, USA.
2
Arizona Neurological Institute, Phoenix, AZ, USA.
3
Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Abstract

STUDY DESIGN:

Cross-sectional analyses.

OBJECTIVE:

To determine whether cervical spinal cord lesions predict the presence of thoracic cord lesions in multiple sclerosis (MS) patients.

SETTING:

Single MS Clinic, AZ, USA.

METHODS:

All MS patients, with MRI studies of the brain, cervical and thoracic spine obtained during a single scanning session, were acquired during a 1-year period. Clinical, demographic and imaging covariates were used in a multivariate regression model to refine predictors of thoracic cord involvement.

RESULTS:

A total of 687 patients were evaluated, and patients were excluded because of a diagnosis of other neurological disorders, not meeting the 2010 McDonald criteria for MS (n=222) or incomplete neuraxis imaging (n=339). The study cohort comprised 126 patients. There was an increase in the odds ratio (OR) of thoracic spine involvement when any cervical spine lesion was present (OR=6.08, 95% confidence interval (2.21-16.68), P<0.001). The multivariate logistic regression model demonstrated a substantial and significant increase in the odds of thoracic spine involvement when more than two cervical spine lesions were present, two lesions (OR 4.44, (0.91-21.60), P=0.06), three lesions (OR 19.76, (3.51-111.17), P=0.001), four or more lesions (OR 20.49, (1.97-213.23), P=0.012) and diffuse lesions (OR 71.94, (5.28-979.88), P=0.001), when adjusting for significant covariates including clinical symptoms, brain lesions, disease duration and treatment exposure.

CONCLUSIONS:

Thoracic spinal cord lesions appear to be predicated on the degree of cervical spine involvement in patients with MS, a risk that appears to be independent of brain findings or clinical features.

PMID:
25582716
DOI:
10.1038/sc.2014.238
[Indexed for MEDLINE]

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