title: Spinal cord lesions and disability in Hispanics with multiple sclerosis.
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.
authors.affiliation: 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, lamezcua@usc.edu.
authors.forename: L
authors.initials: L
authors.lastname: Amezcua
authors.forename: A
authors.initials: A
authors.lastname: Lerner
authors.forename: K
authors.initials: K
authors.lastname: Ledezma
authors.forename: D
authors.initials: D
authors.lastname: Conti
authors.forename: M
authors.initials: M
authors.lastname: Law
authors.forename: L
authors.initials: L
authors.lastname: Weiner
authors.forename: A
authors.initials: A
authors.lastname: Langer-Gould
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology; D006233:Persons with Disabilities; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000453:epidemiology / Q000208:ethnology; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000209:etiology*; D018709:Statistics, Nonparametric; D055815:Young Adult
references.citation: Arch Neurol. 2009 Feb;66(2):226-33
references.pmid: 19204159
references.citation: Radiology. 1995 Jun;195(3):725-32
references.pmid: 7754002
references.citation: Neuroepidemiology. 2009;32(4):294-5
references.pmid: 19246934
references.citation: Arch Neurol. 2006 Dec;63(12):1686-91
references.pmid: 17172607
references.citation: Mult Scler. 2011 Aug;17(8):1010-6
references.pmid: 21467188
references.citation: Int MS J. 2008 Mar;15(1):6-11
references.pmid: 18713563
references.citation: Pathophysiology. 2011 Feb;18(1):69-79
references.pmid: 20494560
references.citation: J Neuroimmunol. 2006 Sep;178(1-2):156-60
references.pmid: 16839613
references.citation: Mult Scler. 2009 Dec;15(12):1450-8
references.pmid: 19965513
references.citation: J Neurol Neurosurg Psychiatry. 2008 Sep;79(9):1022-6
references.pmid: 18356258
references.citation: Neuroepidemiology. 2006;26(1):1-3
references.pmid: 16254448
references.citation: Ethn Dis. 2010 Autumn;20(4):451-7
references.pmid: 21305836
references.citation: Mult Scler. 2001 Aug;7(4):227-9
references.pmid: 11548981
references.citation: J Neurol. 1997 Feb;244(2):76-84
references.pmid: 9120500
references.citation: Mult Scler. 2009 Jul;15(7):887-8
references.pmid: 19542266
references.citation: Neurology. 1983 Nov;33(11):1444-52
references.pmid: 6685237
references.citation: Neurology. 2004 Dec 14;63(11):2039-45
references.pmid: 15596747
references.citation: BMC Genet. 2009 Nov 10;10:71
references.pmid: 19903357
references.citation: J Neurol. 2007 Apr;254(4):488-92
references.pmid: 17401520
references.citation: Am J Phys Med Rehabil. 2003 Aug;82(8):582-90
references.pmid: 12872014
references.citation: J Neurol Sci. 2008 Mar 15;266(1-2):115-25
references.pmid: 17950755
references.citation: J Neurol Neurosurg Psychiatry. 2010 Feb;81(2):209-12
references.pmid: 19710049
references.citation: Neurology. 2006 May 23;66(10):1485-9
references.pmid: 16717206
references.citation: Brain. 1997 Nov;120 ( Pt 11):2059-69
references.pmid: 9397021
references.citation: J Neurol Sci. 2006 Apr 15;243(1-2):21-30
references.pmid: 16376944