Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, PR China.
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, PR China.
Mult Scler Relat Disord. 2020 Jan;37:101426. doi: 10.1016/j.msard.2019.101426. Epub 2019 Oct 1.
Cervical spinal cord atrophy (CSCA), which partly reflects the axonal loss in the spinal cord, is increasingly recognized as a valuable predictor of disease outcome. However, inconsistent results have been reported regarding the correlation of CSCA and clinical disability in multiple sclerosis (MS). The aim of this meta-analysis was to synthesize the available data obtained from 3.0-Tesla (3T) MRI scanners and to explore the relationship between CSCA and scores on the Expanded Disability Status Scale (EDSS).
We searched PubMed, Embase, and Web of Science for articles published from the database inception to February 1, 2019. The quality of the articles was assessed according to a quality evaluation checklist which was created based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. We conducted a meta-analysis of the correlation between EDSS scores and CSCA at 3T MRI in MS.
Twenty-two eligible studies involving 1933 participants were incorporated into our meta-analysis. Our results demonstrated that CSCA was negatively and moderately correlated with EDSS scores (r = -0.42, 95% CI: -0.51 to -0.32; p < 0.0001). Subgroup analyses revealed a weaker correlation in the group of relapsing-remitting multiple sclerosis (RRMS) and clinically isolated syndrome (CIS) (r = -0.19, 95% CI: -0.31 to -0.07; p = 0.0029).
The correlation between CSCA and EDSS scores was significant but moderate. We encourage more studies using reliable and consistent methods to explore whether CSCA is suitable as a predictor for MS progression.
颈椎脊髓萎缩（CSCA）部分反映了脊髓中的轴突丢失，它越来越被认为是疾病结果的一个有价值的预测指标。然而，在多发性硬化症（MS）中，CSCA 与临床残疾之间的相关性的报道结果并不一致。本荟萃分析的目的是综合来自 3.0 特斯拉（3T）磁共振成像（MRI）扫描仪的现有数据，并探讨 CSCA 与扩展残疾状况量表（EDSS）评分之间的关系。
我们在 PubMed、Embase 和 Web of Science 中检索了从数据库创建到 2019 年 2 月 1 日发表的文章。根据基于强化观察性研究报告的流行病学（STROBE）指南制定的质量评估清单评估了文章的质量。我们对 MS 患者的 3T MRI 中 EDSS 评分与 CSCA 之间的相关性进行了荟萃分析。
共有 22 项符合条件的研究纳入了我们的荟萃分析，涉及 1933 名参与者。我们的结果表明，CSCA 与 EDSS 评分呈负相关且中度相关（r=-0.42，95%CI：-0.51 至-0.32；p<0.0001）。亚组分析显示，在复发缓解型多发性硬化症（RRMS）和临床孤立综合征（CIS）亚组中相关性较弱（r=-0.19，95%CI：-0.31 至-0.07；p=0.0029）。
CSCA 与 EDSS 评分之间的相关性是显著的，但程度适中。我们鼓励使用可靠和一致的方法进行更多研究，以探讨 CSCA 是否适合作为 MS 进展的预测指标。
