[Accepted Manuscript] Association of asymptomatic spinal cord lesions and atrophy with disability 5 years after a clinically isolated syndrome.

Article English OPEN
Brownlee, W.J. ; Altmann, D.R. ; Alves Da Mota, P. ; Swanton, J.K. ; Miszkiel, K.A. ; Wheeler-Kingshott, C.G. ; Ciccarelli, O. ; Miller, D.H. (2016)
  • Publisher: SAGE Publications
  • Related identifiers: doi: 10.1177/1352458516663034
  • Subject: Clinically isolated syndrome, multiple sclerosis, MRI, spinal cord

BACKGROUND: Spinal cord pathology is an important substrate for long-term disability in multiple sclerosis (MS). OBJECTIVE: To investigate longitudinal changes in spinal cord lesions and atrophy in patients with a non-spinal clinically isolated syndrome (CIS), and how they relate to the development of disability. METHODS: In all, 131 patients with a non-spinal CIS had brain and spinal cord imaging at the time of CIS and approximately 5 years later (median: 5.2 years, range: 3.0–7.9 years). Brain magnetic resonance imaging (MRI) measures consisted of T2-hyperintense and T1-hypointense lesion loads plus brain atrophy. Spinal cord MRI measures consisted of lesion number and the upper cervical cord cross-sectional area (UCCA). Disability was measured using the Expanded Disability Status Scale (EDSS). Multiple linear regression was used to identify independent predictors of disability after 5 years. RESULTS: During follow-up, 93 (71%) patients were diagnosed with MS. Baseline spinal cord lesion number, change in cord lesion number and change in UCCA were independently associated with EDSS (R2 = 0.53) at follow-up. Including brain T2 lesion load and brain atrophy only modestly increased the predictive power of the model (R2 = 0.64). CONCLUSION: Asymptomatic spinal cord lesions and spinal cord atrophy contribute to the development of MS-related disability over the first 5 years after a non-spinal CIS.
  • References (18)
    18 references, page 1 of 2

    Barnfield, A. (2015). Public health, physical exercise and non-representational theory-a mixed method study of recreational running in Sofia, Bulgaria. Critical Public Health, DOI: 10.1080/09581596.2015.1029434 Barnfield, A., and Plyushteva, A. (2015) Cycling in the post-socialist city: On travelling by bicycle in Sofia, Bulgaria. Urban Studies, DOI: 0042098015586536.

    Barnfield, A. (2016) Grasping Physical Exercise through Recreational Running and Non-Representational Theory - A case study from Sofia, Bulgaria. Sociology of Health and Illness, 38, 7, DOI: 0052300991586816 Bille, M., Bjerregaard, P., and Sørensen, T. F. (2014). Staging Atmospheres: Materiality, culture, and the texture of the in-between. Emotion, Space and Society. Vol. 15, 31-38.

    Burawoy, M. (1998). The extended case method. Sociological theory, 16, 1, 4-33.

    Breckenkamp, J., Blettner, M., and Laaser, U. (2004). Physical activity, cardiovascular morbidity and overall mortality: results from a 14-year follow-up of the German Health Interview Survey. Journal of Public Health 12, 5, 321-328.

    Cummins, S., Curtis, S., Diez, A and Macintyre, S. (2007). Understanding and representing 'place' in health research: A relational approach. Social Science & Medicine, 65, 1825-1838 Damasio, A. (2004). Looking for Spinoza: Joy, sorrow, and the feeling brain. New York: Random House Eurostat. (2012). Europe in Figures: Eurostat Yearbook 2012. Luxemburg: European Union.

    Deleuze, G. (1988a). Bergsonism. New York: Zone Books Deleuze, G. (1988b). Spinoza: practical philosophy. San Francisco, CA: City Lights Books Faramawi, M. F., and Caffrey, J. L. (2010). Linking higher physical activity to lower serum cystatin C among US adults. Journal of Public Health 18, 6, 515-521.

    FIFA (2012) The Laws of the Game 2012/2013, Switzerland: International Football Association Board Frank, L. D., Sallis, J. F., Saelens, B. E., Leary, L., Cain, K., Conway, T. L., and Hess, P. M. (2010). The development of a walkability index: application to the Neighborhood Quality of Life Study. British journal of sports medicine, 44, 13, 924-933 Gil, J. (2006). Paradoxical body. TDR/The Drama Review, 50, 4, 21-35.

    Guattari, F. (1995). Chaosmosis: an ethico-aesthetic paradigm. Indianapolis: Indiana University Press.

    Guattari, F. (1996). The Guattari Reader. G. Genosko (Ed.). London: Blackwell Guattari, F. (2012). Schizoanalytic cartographies. London: Continuum Heath, G. W., Parra, D. C., Sarmiento, O. L., Andersen, L. B., Owen, N., Goenka, S., and Brownson, R. C.

    (2012). Evidence-based intervention in physical activity: lessons from around the world. The Lancet, 380, 9838, 272-281.

  • Metrics
    No metrics available
Share - Bookmark