Evidence map›Paper›PMID 42294820›Full record

ArticleAnnals of clinical and translational neurology2026

Upper Cervical Cord Area as a Biomarker of Conversion to Secondary Progressive Multiple Sclerosis.

Nabil K El Ayoubi, Sola Al Ghazal, Salem Hannoun, Medhat A Siddik, Nour M Najjar, Jim Dagher, Joseph Abboud, Myriam G Semaan, Samia J Khoury

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Article in Annals of clinical and translational neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Nabil K El AyoubiNehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon.ORCID https://orcid.org/0000-0003-0476-0990
Sola Al GhazalDepartment of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Salem HannounMedical Imaging Sciences Program, Division of Health Professions, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.ORCID https://orcid.org/0000-0002-5982-3242
Medhat A SiddikNehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon.ORCID https://orcid.org/0009-0006-6539-3126
Nour M NajjarNehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon.
Jim DagherDepartment of Neurology, UH Cleveland Medical Center, Cleveland, Ohio, USA.
Joseph AbboudNehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon.
Myriam G SemaanNehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon.
Samia J KhouryNehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon.ORCID https://orcid.org/0000-0003-3198-6063

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study assessed whether upper cervical cord area (UCCA) measured on routine brain MRI can serve as a biomarker of conversion to SPMS.

methodsThis is a single-center retrospective cohort study of RRMS patients with cross-sectional and longitudinal analyses of clinical and MRI data. Future SPMS converters were matched by age, sex, and disease duration with non-converters. UCCA at C1-C3 was measured at a pre-conversion visit in converters and at the first available visit in non-converters. Analysis was performed using Pearson's correlation and multivariable logistic regression. Longitudinal analyses included patients with ≥ 6 months MRI interval (mean follow-up 3.38 ± 1.88 years).

results97 patients (32 converters, 65 non-converters) were included. Cross-sectionally, reduced C2 and C3 area was associated with conversion (C2: OR 1.09, p = 0.01; C3: OR 1.09, p = 0.014). Lower UCCA correlated with higher EDSS (C2: r = -0.496, p < 0.001), worse T25-FWT (C2: r = -0.388, p < 0.001) and 9-HPT (C2: r = -0.312, p = 0.003), and reduced white matter and thalamic volumes (p ≤ 0.006). Longitudinal analysis (n = 50; 16 converters, 34 non-converters) demonstrated atrophy in converters at C1, C2 and C3 (C1: OR 1.70, p = 0.014; C2: OR 1.74, p = 0.003; C3: OR 1.75, p = 0.002), with mean annual percent reductions of 5.0%, 5.2%, and 6.0%, respectively.

interpretationReduced UCCA and accelerated upper cervical cord atrophy were associated with conversion to SPMS and worsening disability, supporting UCCA as an accessible imaging biomarker of MS progression.

Indexed as

brain volumetrymagnetic resonance imagingsecondary progressive multiple sclerosisspinal cord atrophyupper cervical cord area

Identifiers

PMID42294820
PMCPMC13395063

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