ArticleBrain : a journal of neurology2020
Multiple sclerosis lesions in motor tracts from brain to cervical cord: spatial distribution and correlation with disability.
Article in Brain : a journal of neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers.
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Who cites it
42 citing papers in PubMed, 57 citations in OpenAlex.
- Multi-compartment Myelin Streamline Decomposition reveals tract-specific and global brain network myelination in Multiple Sclerosis.Neuroimage. Reports · 2026Article
- Structure-Function Decoupling of the Sensorimotor and Default Mode Networks in Black Americans With MS.Annals of clinical and translational neurology · 2026Article
- Article
- White matter microstructure of sensorimotor projection fibers in chronic low back pain.Pain reports · 2026Article
- CD11c+ CD8 T cells cause IFN-γ-dependent autoimmune neuroinflammation that is restrained by PD-1 signaling.JCI insight · 2026Article
- Association Between Motor Pathway Damage and Motor Deficit in Upper and Lower Limb in People With MS.Annals of clinical and translational neurology · 2026Article
- Generalizable spinal cord multiple sclerosis lesion segmentation across MRI contrasts, protocols, and centers.Multiple sclerosis (Houndmills, Basingstoke, England) · 2026Article
- Early-Age Cuprizone Exposure Induces Region-Specific Demyelination and Neuroinflammation in Mice.Neuromolecular medicine · 2026Article
- Motor tract lesion mapping from the brain to the lower spinal cord in people with relapsing-remitting multiple sclerosis: exploring the association between lesion severity and functional consequences by limb.Brain communications · 2026Article
- Disability Worsening Phenotypes in Multiple Sclerosis and Impact of Disease-Modifying Treatments.Neurology · 2025Article
- Cervical cord atrophy correlates with intracranial lesion burden in tumefactive multiple sclerosis.Journal of neurology · 2025Article
- Critical demyelinating lesions in progressive multiple sclerosis: a prospective observational study.Journal of neurology · 2025Observational
- Evaluation of a deep learning segmentation tool to help detect spinal cord lesions from combined T2 and STIR acquisitions in people with multiple sclerosis.European radiology · 2025Article
- Fractal-Based Architectures with Skip Connections and Attention Mechanism for Improved Segmentation of MS Lesions in Cervical Spinal Cord.Diagnostics (Basel, Switzerland) · 2025Article
- Clinical and MRI features contributing to the clinico-radiological dissociation in a large cohort of people with multiple sclerosis.Journal of neurology · 2025Article
- Identifying Biomarkers for Remyelination and Recovery in Multiple Sclerosis: A Measure of Progress.Biomedicines · 2025Review
- Automatic segmentation of spinal cord lesions in MS: A robust tool for axial T2-weighted MRI scans.Imaging neuroscience (Cambridge, Mass.) · 2025Article
- Leveling up: along-level diffusion tensor imaging in the spinal cord of multiple sclerosis patients.Frontiers in neuroimaging · 2025Article
- MR Imaging Features of Critical Spinal Demyelinating Lesions Associated with Progressive Motor Impairment.AJNR. American journal of neuroradiology · 2024Observational
- Reproducible Spinal Cord Quantitative MRI Analysis with the Spinal Cord Toolbox.Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine · 2024Review
Corrections and comments
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Authors and funding
36 authors at 12 institutions in 6 countries.
Funding
Abstract
Despite important efforts to solve the clinico-radiological paradox, correlation between lesion load and physical disability in patients with multiple sclerosis remains modest. One hypothesis could be that lesion location in corticospinal tracts plays a key role in explaining motor impairment. In this study, we describe the distribution of lesions along the corticospinal tracts from the cortex to the cervical spinal cord in patients with various disease phenotypes and disability status. We also assess the link between lesion load and location within corticospinal tracts, and disability at baseline and 2-year follow-up. We retrospectively included 290 patients (22 clinically isolated syndrome, 198 relapsing remitting, 39 secondary progressive, 31 primary progressive multiple sclerosis) from eight sites. Lesions were segmented on both brain (T2-FLAIR or T2-weighted) and cervical (axial T2- or T2*-weighted) MRI scans. Data were processed using an automated and publicly available pipeline. Brain, brainstem and spinal cord portions of the corticospinal tracts were identified using probabilistic atlases to measure the lesion volume fraction. Lesion frequency maps were produced for each phenotype and disability scores assessed with Expanded Disability Status Scale score and pyramidal functional system score. Results show that lesions were not homogeneously distributed along the corticospinal tracts, with the highest lesion frequency in the corona radiata and between C2 and C4 vertebral levels. The lesion volume fraction in the corticospinal tracts was higher in secondary and primary progressive patients (mean = 3.6 ± 2.7% and 2.9 ± 2.4%), compared to relapsing-remitting patients (1.6 ± 2.1%, both P < 0.0001). Voxel-wise analyses confirmed that lesion frequency was higher in progressive compared to relapsing-remitting patients, with significant bilateral clusters in the spinal cord corticospinal tracts (P < 0.01). The baseline Expanded Disability Status Scale score was associated with lesion volume fraction within the brain (r = 0.31, P < 0.0001), brainstem (r = 0.45, P < 0.0001) and spinal cord (r = 0.57, P < 0.0001) corticospinal tracts. The spinal cord corticospinal tracts lesion volume fraction remained the strongest factor in the multiple linear regression model, independently from cord atrophy. Baseline spinal cord corticospinal tracts lesion volume fraction was also associated with disability progression at 2-year follow-up (P = 0.003). Our results suggest a cumulative effect of lesions within the corticospinal tracts along the brain, brainstem and spinal cord portions to explain physical disability in multiple sclerosis patients, with a predominant impact of intramedullary lesions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.