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The following is a summary of “Association of the Cervical Canal Area With Disability and Progression in People With Multiple Sclerosis,” published in the December 2024 issue of Neurology by Mongay-Ochoa et al.
In multiple sclerosis (MS), the spinal cord reserve, similar to the brain reserve, may help protect against physical disability.
Researchers conducted a retrospective study to explore the cervical canal area (CCaA) as a potential marker for spinal cord reserve in people with multiple sclerosis (PwMS).
They included 428 PwMS and 177 HCs from 9 European MAGNIMS sites. Cervical 3D T1-weighted images were used to estimate the CCaA at C2/C3 and C3/C4 levels. The Expanded Disability Status Scale (EDSS) scores were measured at baseline and 5 years. Multivariable regression models, adjusted for age, sex, spinal cord parenchymal fraction (SCPF), and cervical cord lesions, were applied.
The results showed that people with progressive MS (PwPMS) had a significantly smaller CCaA at both the C2/C3 (210.51 mm2, estimated mean difference [EMD] −4.11, 95% CI −6.28 to −1.00, P=0.007) and C3/C4 (165.16 mm2, EMD −4.51, 95% CI −5.50 to −1.60, P<0.001) levels compared to HCs (214.62 mm2 and 169.67 mm2, respectively) and people with relapsing MS (PwRMS) (213.68 mm2 and 169.44 mm2, respectively). Baseline CCaA at C3/C4 was significantly associated with EDSS scores (β = −0.13, P<0.001). People with clinical worsening at the 5-year follow-up had smaller baseline CCaA (worsened: 167.03 mm2 vs. stable: 169.13 mm2, EMD −2.10, 95% CI −3.98 to −0.23, P=0.028).
They concluded that CCaA may be a novel radiologic marker of physical disability and disease progression in PwMS.
Source: neurology.org/doi/10.1212/WNL.0000000000210136
