Data from: Clinically relevant cranio-caudal patterns of cervical cord atrophy evolution in MS

Objectives. To characterize the distribution and regional evolution of
cervical cord atrophy in multiple sclerosis (MS) patients in a multicentre
dataset. Methods. MRI and clinical evaluations were acquired from 179
controls and 435 patients (35 clinically isolated syndromes [CIS], 259
relapsing-remitting [RR], 99 secondary-progressive [SP] and 42
primary-progressive [PP]MS). Sixty-nine controls and 178 patients
underwent a one-year MRI and clinical follow-up. Patients were classified
as clinically stable/worsened according to their disability change.
Longitudinal changes of cord atrophy were investigated with linear
mixed-effect models. Sample size calculations were performed using age-,
sex- and site-adjusted annualized percentage normalized cord
cross-sectional area (CSAn) changes..Results. Baseline CSAn was lower in
MS patients vs controls (p<0.001), but not different between
controls and CIS or between early RRMS (disease duration<5 years)
and CIS patients. Late RRMS (disease duration>5 years) showed
significant cord atrophy vs early RRMS (p=0.02). Progressive MS patients
had decreased CSAn (p<0.001) vs RRMS. Atrophy was located between
C1/C2 and C5 in RRMS vs CIS, and widespread along the cord in progressive
MS vs RRMS, with an additional C5/C6 involvement in SPMS vs PPMS. At
follow-up, CSAn decreased in all phenotypes (p<0.001), except CIS.
Cord atrophy rates were highest in early RRMS and clinically worsened
patients, who had a more widespread cord involvement than stable patients.
The sample size per arm required to detect a 50% treatment effect was 118
for early RRMS patients. Conclusions. Cord atrophy increased in MS during
one year, except for CIS. A faster atrophy contributed to explain clinical
worsening.