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Cited by 153Multiple Sclerosis Research StudiesClinical Reasoning and Diagnostic SkillsPolyomavirus and related diseases

Spinal cord lesions in patients with clinically isolated syndrome: A powerful tool in diagnosis and prognosis

Sombekke, Madeleine H., Wattjes, Mike P., Balk, Lisanne J., Nielsen, Jessica M., Vrenken, Hugo, Uitdehaag, Bernard M.J., Polman, Chris H., Barkhof, Frederik·2013·Neurology
DOI 10.1212/wnl.0b013e31827b1a67
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Abstract

Objective Spinal cord (SC) lesions are frequently found in multiple sclerosis (MS), but are rare in healthy aging and cerebrovascular patients. Our aim was to analyze the contribution of SC involvement in clinically isolated syndrome (CIS) in diagnosing MS according the McDonald 2010 criteria and in predicting conversion to clinically definite MS (CDMS). Methods We prospectively followed monofocal, relapsing onset CIS patients with either SC or brain symptom onset (including optic neuritis). MRI of the brain and SC were performed shortly after onset and patients were followed for 24 to 119 months (median 64 months). SC MRI findings were assessed for their contribution to the McDonald 2010 diagnostic criteria and their effect on conversion to CDMS. Results One hundred twenty-one patients were included (63 spinal CIS). Based on the brain scan only, 36 patients fulfilled the McDonald criteria; by including SC findings, 6 additional patients fulfilled these criteria. To diagnose 1 additional nonspinal CIS patient, the number needed to scan is 7. In nonspinal CIS patients that did not fulfill McDonald brain MRI criteria (n = 42), presence of an SC lesion was associated with a higher risk of conversion to CDMS (odds ratio: 14.4; 95% confidence interval: 2.6-80.0) and shorter time to conversion to CDMS (hazard ratio: 51.4; 95% confidence interval: 5.5-476.3). Conclusions Presence of SC lesions facilitates diagnosing MS and is predictive for conversion to CDMS, especially in patients…

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Crossref · 10.1212/wnl.0b013e31827b1a67

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  • Spinal cord lesions occur in 80-90% of patients with established MS and up to half of patients with CIS, most often in the cervical cord.

    “Spinal cord lesions occur in 80-90% of patients with established MS and up to half of patients with CIS, most often in the cervical cord.10,11”

    From Diagnosis of multiple sclerosis: progress and challenges (2017) · cites this paper as [10]

  • Spinal cord lesions can be very helpful in making a diagnosis of MS (cord lesions do not occur with healthy aging or cerebrovascular disease and provide additional evidence of dissemination in space) and may provide important prognostic information.

    “However, spinal cord lesions can be very helpful in making a diagnosis of MS (cord lesions do not occur with healthy aging or cerebrovascular disease 11 and provide additional evidence of dissemination in space 10 ) and may provide important prognostic information.67”

    From Diagnosis of multiple sclerosis: progress and challenges (2017) · cites this paper as [10]

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Authors
Sombekke, M. H., Wattjes, M. P., Balk, L. J., Nielsen, J. M., Vrenken, H., Uitdehaag, B. M. J., Polman, C. H., & Barkhof, F.
Affiliations
Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
ORCID
Venue
Neurology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2013-01
Volume
80
Issue
1
Pages
69-75
ISSN
  • 0028-3878 (ISSN-L)
  • 1526-632X
DOI
10.1212/wnl.0b013e31827b1a67
OpenAlex
W2026283135
Cited by
153
References
2
Citations by year
2026: 7 · 2025: 3 · 2024: 7 · 2023: 7 · 2022: 8 · 2021: 12 · 2020: 16 · 2019: 16 · 2018: 16 · 2017: 15 · 2016: 18 · 2015: 14 · 2014: 10 · 2013: 4
FWCI
6.45
Type
journal article
Language
en
Open access
closed
Locations
  • Neurology (publishedVersion)
  • PubMed (publishedVersion)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
  • VU Research Portal (publishedVersion)
  • Pure Amsterdam UMC (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
  • Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
  • Health Sciences › Medicine › Oncology › Polyomavirus and related diseases
Keywords
spinal cord lesions, clinically isolated syndrome, multiple sclerosis diagnosis, conversion to clinically definite multiple sclerosis, spinal cord MRI, optic neuritis, time to conversion
MeSH terms
Adult, Brain, Demyelinating Diseases, Female, Humans, Magnetic Resonance Imaging, Male, Multiple Sclerosis, Predictive Value of Tests, Prognosis, Prospective Studies, Severity of Illness Index, Spinal Cord, Disease Progression, Neuroimaging

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