Assessment of spinal cord involvement in multiple sclerosis patients at the onset of illness and over time

Abstract

Multiple sclerosis (MS) is a chronic disease of the central nervous system that is considered as one of the debilitating disorders, especially in young people. Spinal cord involvement in MS patients increases the severity of the disease in patients. Considering the differences in the prevalence of spinal cord involvement in different studies and the lack of a study in Iran on the incidence of spinal cord involvement in patients with MS, the aim of this study was to evaluate the rate of spinal cord involvement in MS patients using MRI findings Materials and Methods: This cross-sectional study was performed on 302 patients with MS. Patients MRIs were examined for cervical and thoracic spinal involvement. In addition to spinal cord involvement information, patients' demographics including age and gender, the initial symptom of diseases, disease type and EDSS score were also collected and statistically analyzed. Results: In this study, the mean age of patients was 35.4±9.6 years and 71.8% of them were women. The disease duration was 6.7±5.6 years and the mean EDSS score was 2.1±2. The most common early symptoms of patients were sensory symptoms, optic neuritis, and motor symptoms, respectively. Relapsing Remitting (RR) phenotype was the most common MS phenotype with a frequency of about 80%. According to 2013 MRIs, 71.8% of patients had spinal cord involvement, and during 2013-2018 the rate of spinal cord involvement increased by about 24%. C2 (19%), C3 (15.7%) and C5 (14.4%) vertebrae were the most common sites of lesions, respectively; and most patients (38.4%) had 2 lesions. There was no significant relationships between patients' gender with severity of spinal involvement, but there were significant relationships between spinal cord involvement in patients with age, disease duration, type of MS phenotype, number of spinal cord lesions and EDSS score of patients (all cases P <0.05).