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The course of cervical spinal cord atrophy rate and its relationship with NEDA in relapsing remitting multiple sclerosis

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Abstract

This study aimed to compare the annualized segmental cervical spinal cord atrophy rate (ASCAR) in the early and late stages of relapsing remitting multiple sclerosis (RRMS), and to investigate the relationship between ASCAR and no evidence of disease activity (NEDA) in RRMS. Participants in this study included early stage MS (EMSg) patients, late stage MS (LMSg) patients, and healthy controls. All of the included participants (n = 175 subjects) were followed up for 14 months, and an MRI was performed on each participant at the beginning and at the end of the study. Cervical spinal cord average segmental area (CSCA) was measured by a semi-automated method, and ASCAR (mm2/year) was calculated. Data from the EMSg (n = 81 subjects) and LMSg (n = 94 subjects) patient groups were compared with each other and with the control group (n = 43 subjects). Examination of the initial CSCA values revealed that the baseline CSCA of the control group was larger than that of the EMSg (p < 0.001), and the baseline CSCA of the EMSg was larger than that of the LMSg (p < 0.001). The ASCAR of the control group, LMSg, and EMSg were 0.48, 0.93, and 1.81 mm2 (p < 0.001), respectively. Regression analysis revealed that disability increase was associated with ASCAR, while MRI activity and relapse presence were unrelated to ASCAR. In both patient groups, ASCAR was slower in those who fulfilled NEDA but this relationship was not significant. Cervical spinal cord atrophy progression over time occurs at a greater rate in the early stages of RRMS disease compared to the late stages. ASCAR was unrelated to MRI activity and relapse, which are clinical markers of acute inflammation.

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Supporting information is available in the additional files and further supporting data are available from the authors on request.

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Acknowledgements

The authors thank all the people who took part in this study.

Funding

This research did not receive any specific grant from funding agencies.

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Authors and Affiliations

  1. Van Yuzuncu Yil University Faculty of Medicine Neurology Department, Kampus, 65300, Tusba, Van, Turkey

    Vedat Cilingir

  2. Van Yuzuncu Yil University Faculty of Medicine Radiology Department, Van, Turkey

    Hüseyin Akdeniz

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  1. Vedat Cilingir
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  2. Hüseyin Akdeniz
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Contributions

VC designed the study, carried out the neurologic examinations, and follow-up visits; HA was involved in planning and performed the radiologic measurements and calculations. VC analyzed the data and wrote the manuscript, while HA provided critical feedback.

Corresponding author

Correspondence to Vedat Cilingir.

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Ethics approval

The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. All of the included subjects provided written informed consent, and the study protocol was accepted by the local ethics committee of our university (2018/08-02).

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Vedat Cilingir and Huseyin Akdeniz hereby declare that we give our consent for the article to be published in Acta Neurologica Belgica.

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The authors have no conflicts of interest to declare.

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Cilingir, V., Akdeniz, H. The course of cervical spinal cord atrophy rate and its relationship with NEDA in relapsing remitting multiple sclerosis. Acta Neurol Belg 122, 345–355 (2022). https://doi.org/10.1007/s13760-021-01595-4

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  • DOI: https://doi.org/10.1007/s13760-021-01595-4

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