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Spinal cord lesions and disability in Hispanics with multiple sclerosis

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Abstract

Longitudinally extensive spinal cord lesions (LESCLs) are believed to occur predominantly with opticospinal multiple sclerosis (OSMS) and are associated with disability. The purpose of this study is to describe the prevalence and patterns of spinal cord lesions in Hispanics with multiple sclerosis (MS) and OSMS and their association with disability. A cross-sectional study of 164 patients with complete MRIs was used. In each case the spinal cord was classified: LESCLs, scattered spinal cord lesions (sSCLs) or no spinal cord lesions (noSCLs). Clinical course was defined as classical MS or OSMS. Risk of disability (Expanded Disability Status Scale ≥4.0) was adjusted for age, disease duration and sex using logistic regression. A total of 125/164 (73 %) MS patients had spinal cord lesions (sSCLs, 57 %; LESCLs, 19 %), but only 11 (7 %) had OSMS. LESCLs were associated with disability (p < 0.0001), longer disease duration (p < 0.0001) and MS (n = 21 vs. n = 10 OSMS; p < 0.0001). LESCLs were also associated with the greatest risk to disability (OR 7.3, 95 % CIs 1.9–26.5; p = 0.003; sSCLs OR 2.5, 95 % CIs 0.9–7.1; p = 0.09) compared with noSCLs. LESCLs are more common than OSMS and are associated with worse disability even in patients with MS. These results suggest that LESCLs are a more important marker of disability in MS than OSMS and may be an early indicator of more aggressive disease in this population.

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Acknowledgement

The authors thank Christen Weber, Abraham Aguilar, and Maura Fernandez for their contributions to data collection/recruitment and the subjects from the Hispanics with MS registry for their participation in the study. This work was supported by National Center for Advancing Translational Sciences, National Institutes of Health (NIH), through Grant Award Number KL2TR000131 and Nancy Davis Foundation young investigator award to L. Amezcua.

Conflicts of interest

Dr. Amezcua has received honoraria for advisory boards and grant support from Acorda, Biogen and Novartis. Dr. Weiner has received consulting honoraria from Teva and Genzyme. Dr. Law has a research grant from Bayer Healthcare, receives honoraria from Toshiba Medical, iCAD Inc, Fuji Film, Bracco Diagnostics. All others have nothing to report.

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Authors and Affiliations

  1. Department of Neurology, Keck School of Medicine, MS Comprehensive Care Center, University of Southern California (USC), 1520 San Pablo St, Suite 3000, Los Angeles, CA, 90033, USA

    L. Amezcua, K. Ledezma & L. Weiner

  2. Department of Radiology, Neuroradiology, University of Southern California (USC), Los Angeles, USA

    A. Lerner & M. Law

  3. Division of Biostatistics, Department of Preventive Medicine, University of Southern California (USC), Los Angeles, USA

    D. Conti

  4. Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, USA

    A. Langer-Gould

  5. Department of Neurology, Keck School of Medicine, University of Southern California (USC), Los Angeles, USA

    A. Langer-Gould

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  1. L. Amezcua
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  2. A. Lerner
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  3. K. Ledezma
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  4. D. Conti
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  5. M. Law
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  6. L. Weiner
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  7. A. Langer-Gould
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Correspondence to L. Amezcua.

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Amezcua, L., Lerner, A., Ledezma, K. et al. Spinal cord lesions and disability in Hispanics with multiple sclerosis. J Neurol 260, 2770–2776 (2013). https://doi.org/10.1007/s00415-013-7054-4

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  • DOI: https://doi.org/10.1007/s00415-013-7054-4

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