Observational studyAJNR. American journal of neuroradiology2024
MR Imaging Features of Critical Spinal Demyelinating Lesions Associated with Progressive Motor Impairment.
Observational study in AJNR. American journal of neuroradiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Spinal cord imaging in multiple sclerosis: from diagnosis to disease progression.Journal of neurology · 2026Review
- Progressive motor impairment from intracerebral critical demyelinating lesions.Journal of neurology · 2026Article
- Clinical course of critical demyelinating lesion-associated progressive multiple sclerosis.Journal of neurology · 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
- 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
- Volumetric MRI Comparing Longitudinal Change in MOGAD to NMOSD, MS and Healthy Controls, and Disability Associations.Annals of 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
- The Link Between Paraquat and Demyelination: A Review of Current Evidence.Antioxidants (Basel, Switzerland) · 2024Review
- Spinal cord evaluation in multiple sclerosis: clinical and radiological associations, present and future.Brain communications · 2024Review
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Authors and funding
14 authors.
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No grant is acknowledged in the PubMed record.
Abstract
background and purposeProgressive MS is typically heralded by a myelopathic pattern of asymmetric progressive motor weakness. Focal individual "critical" demyelinating spinal cord lesions anatomically associated with progressive motor impairment may be a compelling explanation for this clinical presentation as described in progressive solitary sclerosis (single CNS demyelinating lesion), progressive demyelination with highly restricted MR imaging lesion burden (2-5 total CNS demyelinating lesions; progressive paucisclerotic MS), and progressive, exclusively unilateral hemi- or monoparetic MS (>5 CNS demyelinating progressive unilateral hemi- or monoparetic MS [PUHMS] lesions). Critical demyelinating lesions appear strikingly similar across these cohorts, and we describe their specific spinal cord MR imaging characteristics. MATERIALS AND
methodsWe performed a retrospective, observational MR imaging study comparing spinal cord critical demyelinating lesions anatomically associated with progressive motor impairment with any additional "noncritical" (not anatomically associated with progressive motor impairment) spinal cord demyelinating lesions. All spinal cord MR images (302 cervical and 91 thoracic) were reviewed by an experienced neuroradiologist with final radiologic assessment on the most recent MR imaging. Anatomic association with clinical progressive motor impairment was confirmed independently by MS subspecialists.
resultsNinety-one individuals (PUHMS, 37 [41%], progressive paucisclerosis 35 [38%], progressive solitary sclerosis 19 [21%]) with 91 critical and 98 noncritical spinal cord MR imaging demyelinating lesions were evaluated. MR imaging characteristics that favored critical spinal cord demyelinating lesions over noncritical lesions included moderate-to-severe, focal, lesion-associated spinal cord atrophy: 41/91 (45%) versus 0/98 (0%) (OR, 161.91; 9.43 to >999.9); lateral column axial location (OR, 10.43; 3.88-28.07); central region (OR, 3.23; 1.78-5.88); ventral column (OR, 2.98; 1.55-5.72); and larger lesion size of the axial width (OR, 2.01;1.49-2.72), transverse axial size (OR, 1.66; 1.36-2.01), or lesion area (OR, 1.14; 1.08-1.2). Multiple regression analysis revealed focal atrophy and lateral axial location as having the strongest association with critical demyelinating lesions.
conclusionsFocal, lesion-associated atrophy, lateral column axial location, and larger lesion size are spinal cord MR imaging characteristics of critical demyelinating lesions. The presence of critical demyelinating lesions should be sought as these features may be associated with the development of progressive motor impairment in MS.
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