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Recurrence and Prognostic Value of Asymptomatic Spinal Cord Lesions in Multiple Sclerosis

Multiple Sclerosis Center, Department of Neurology, Neurocenter of Southern Switzerland, Ospedale Civico, Via Tesserete 46, 6903 Lugano, Switzerland
Department of Health Sciences, University of Genova, 16132 Genova, Italy
Department of Neuroradiology, Neurocenter of Southern Switzerland, 6900 Lugano, Switzerland
IRCCS, Ospedale Policlinico San Martino, 16132 Genova, Italy
Faculty of Biomedical Sciences, Università della Svizzera Italiana, Via Buffi 13, 6900 Lugano, Switzerland
Author to whom correspondence should be addressed.
J. Clin. Med. 2021, 10(3), 463;
Received: 18 December 2020 / Revised: 13 January 2021 / Accepted: 19 January 2021 / Published: 26 January 2021
(This article belongs to the Section Clinical Neurology)
Spinal magnetic resonance imaging (MRI) is currently not recommended for the routine monitoring of clinically stable multiple sclerosis (MS) patients. We aimed to investigate the occurrence of asymptomatic spinal lesions (a-SL) in clinically stable MS patients, and their association with clinical and radiological outcomes, including the recurrence of spinal lesions. The hospital MS registry was searched for clinically stable MS patients (no relapses, no disability progression) with spinal MRIs performed at T1 (baseline) and T2 (9–36 months after T1). Information on relapses, disability and new brain/spinal MRI lesions at T3 (≥6 months after T2) was collected and analyzed. Out of 300 MS patients, 45 showed a-SL between T1 and T2. The presence of a-SL was not associated with the subsequent occurrence of relapses or disability progression at T3, but did correlate with the risk of new brain (rate ratio (RR) = 1.63, 95% CI = 1.16−2.25, p = 0.003) and recurrent spinal lesions (RR = 7.28, 95% CI = 4.02–13.22, p < 0.0001). Accounting for asymptomatic brain lesions (a-BL), the presence of either a-BL or a-SL was associated with subsequent risk for new brain (OR = 1.81, 95% CI = 1.25–2.60, p = 0.001) or spinal (RR = 2.63, 95% CI = 1.27–5.45, p = 0.009) lesions. Asymptomatic spinal demyelinating lesions occurred in 15% of clinically stable MS patients within a median period of 14 months and conferred an increased risk of future radiological activity at the brain and spinal level. View Full-Text
Keywords: multiple sclerosis; spinal lesions; asymptomatic; prediction; MRI multiple sclerosis; spinal lesions; asymptomatic; prediction; MRI
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MDPI and ACS Style

Ostini, C.; Bovis, F.; Disanto, G.; Ripellino, P.; Pravatà, E.; Sacco, R.; Padlina, G.; Sormani, M.P.; Gobbi, C.; Zecca, C. Recurrence and Prognostic Value of Asymptomatic Spinal Cord Lesions in Multiple Sclerosis. J. Clin. Med. 2021, 10, 463.

AMA Style

Ostini C, Bovis F, Disanto G, Ripellino P, Pravatà E, Sacco R, Padlina G, Sormani MP, Gobbi C, Zecca C. Recurrence and Prognostic Value of Asymptomatic Spinal Cord Lesions in Multiple Sclerosis. Journal of Clinical Medicine. 2021; 10(3):463.

Chicago/Turabian Style

Ostini, Camilla, Francesca Bovis, Giulio Disanto, Paolo Ripellino, Emanuele Pravatà, Rosaria Sacco, Giovanna Padlina, Maria P. Sormani, Claudio Gobbi, and Chiara Zecca. 2021. "Recurrence and Prognostic Value of Asymptomatic Spinal Cord Lesions in Multiple Sclerosis" Journal of Clinical Medicine 10, no. 3: 463.

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