Saini Aman, Bach Kevin, Poliakov Ilia, Knox Katherine B, Levin Michael C
Int J MS Care. 2021 Mar-Apr;23(2):47-52. doi: 10.7224/1537-2073.2019-081. Epub 2020 Apr 14.
Spinal cord lesions (SCLs) contribute to disability in multiple sclerosis (MS). Data in Saskatchewan, Canada, concerning SCLs and their association with disability levels in patients with MS are lacking. The study objectives were to identify clinicodemographic profiles of patients with MS with respect to spinal cord magnetic resonance imaging (MRI) involvement; determine the frequency of individuals with MRI SCLs; and explore differences between patients with MS with and without SCLs with respect to disability and disease-modifying therapy status.
A monocentric, cross-sectional, retrospective review of prospectively collected data from 532 research-consented patients seen at Saskatoon MS Clinic was performed. Data were collected from a database and electronic medical records.
Of the 356 patients (66.9%) with an SCL, 180 (50.6%) had only cervical cord lesions. Median Expanded Disability Status Scale (EDSS), ambulation, and pyramidal scores of patients with SCLs were higher than those of patients without SCLs. Of patients with EDSS scores of at least 6, those with SCLs were younger than those without SCLs ( = .01). Patients with SCLs were 55% less likely to have been on continuous disease-modifying therapy since diagnosis than patients without SCLs (adjusted odds ratio, 0.45; 95% CI, 0.25-0.81; = .008).
Prevalence and association with disability of SCLs in patients with MS are comparable with existing literature. Patients with MS with SCLs have higher levels of disability and attain EDSS scores of at least 6 at a younger age.
脊髓病变(SCLs)会导致多发性硬化症(MS)患者出现残疾。加拿大萨斯喀彻温省缺乏关于SCLs及其与MS患者残疾水平关联的数据。本研究的目的是确定MS患者在脊髓磁共振成像(MRI)受累方面的临床人口统计学特征;确定MRI显示有SCLs的个体频率;并探讨有和没有SCLs的MS患者在残疾和疾病修饰治疗状态方面的差异。
对在萨斯卡通MS诊所就诊的532名同意参与研究的患者的前瞻性收集数据进行了单中心、横断面、回顾性分析。数据从数据库和电子病历中收集。
在356例(66.9%)有SCL的患者中,180例(50.6%)仅有颈髓病变。有SCL的患者的扩展残疾状态量表(EDSS)、步行能力和锥体束评分中位数高于无SCL的患者。在EDSS评分至少为6分的患者中,有SCL的患者比无SCL的患者年轻(P = 0.01)。自诊断以来,有SCL的患者接受持续疾病修饰治疗的可能性比无SCL的患者低55%(调整后的优势比为0.45;95%置信区间为0.25 - 0.81;P = 0.008)。
MS患者中SCLs的患病率及其与残疾的关联与现有文献相当。有SCL的MS患者残疾水平更高,且在更年轻的时候EDSS评分就至少达到6分。