Relevance of asymptomatic spinal MRI lesions in patients with multiple sclerosis

C. Zecca, G. Disanto, M. P. Sormani, G. C. Riccitelli, A. Cianfoni, F. Del Grande, E. Pravatà, C. Gobbi

Research output: Contribution to journalArticlepeer-review


Background: The impact of new asymptomatic spinal cord lesions (a-SL) in multiple sclerosis (MS) course is poorly characterized. Objective: The objective of this research paper is to assess the prognostic value of a-SL in predicting MS course. Methods: Relapsing-remitting MS patients who received serial MRI (brain and spinal) at baseline (t1) and within 12 to 36 months (t2) during clinical stability, and had a follow-up (t2-t3) 24 months were included. Relapses and disability progression were evaluated between t2 and t3. Results: Of 413 consecutive screened MS patients, 103 patients (65 females, median age 43 years) were included. After a median t1-t2 interval of 17 (IQR 13-26) months, 25.2% and 43.7% patients had 1 new a-SL (a-SL+) and asymptomatic brain lesions (a-BL+), respectively. Relapse risk between t2 and t3 (median interval: 42 (IQR 32-57.5) months) was significantly increased in a-SL+ and/or a-BL+ vs a-BL- and a-SL- (HR = 2.31, 95% CI = 1.13-4.72, p = 0.02). No differences in the risk of disability progression were found in a-SL+ and/or a-BL+ vs a-SL- and a-BL-. Conclusion: a-SL occur in one-quarter of clinically stable RRMS, and combined with a-BL contribute significantly in predicting future disease course.

Original languageEnglish (US)
Pages (from-to)782-791
Number of pages10
JournalMultiple Sclerosis Journal
Issue number6
StatePublished - May 2016
Externally publishedYes


  • Diagnosis
  • MRI
  • Multiple sclerosis
  • Nervous system
  • Nervous system diseases
  • Spinal cord
  • T2 lesions

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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