Abstract
Leptomeningeal contrast enhancement (LMCE) on magnetic resonance imaging (MRI) is a newly recognized possible biomarker in multiple sclerosis (MS), associated with MS progression and cortical atrophy. In this study, we aimed to assess the prevalence of LMCE foci and their impact on neurodegeneration and disability. Materials. 54 patients with MS were included in the study. LMCE were detected with a 3 Tesla scanner on postcontrast fluid-attenuated inversion-recovery (FLAIR) sequence. Expanded Disability Status Scale (EDSS) score, number of relapses during 5 years from MS onset, and number of contrast-enhancing lesions on T1 weighted MRI were counted. Results. LMCE was detected in 41% (22/54) of patients. LMCE-positive patients had longer disease duration (p = 0,0098) and higher EDSS score (p = 0,039), but not a higher relapse rate (p = 0,091). No association of LMCE with higher frequency of contrast-enhancing lesions on T1-weighted images was detected (p = 0,3842). Analysis of covariates, adjusted for age, sex, and disease duration, revealed a significant effect of LMCE on the cortex volume (p = 0.043, F = 2.529), the total grey matter volume (p = 0.043, F = 2.54), and total ventricular volume (p = 0.039, F = 2.605). Conclusions. LMCE was shown to be an independent and significant biomarker of grey matter atrophy and disability in MS.
Highlights
Multiple sclerosis is a chronic debilitating disease of the central nervous system (CNS)
We aimed to study the prevalence of magnetic resonance imaging (MRI) Leptomeningeal contrast enhancement (LMCE) foci and their impact on neurodegeneration and disability in a cross-sectional cohort of patients with multiple sclerosis (MS)
This finding may be explained by rather high median Expanded Disability Status Scale (EDSS) score in the investigated cohort due to more patients on advanced stages of the disease, which may increase the proportion of LMCE-positive patients
Summary
Multiple sclerosis is a chronic debilitating disease of the central nervous system (CNS). Recent studies have demonstrated a prominent neurodegenerative component starts early in the disease course [1, 2]. Grey matter pathology in MS is prominent in both deep grey matter structures (thalamus, etc.) and cortex. Cortical pathology has been shown to be prominent in advanced stages of secondary and primary progressive MS [5]. A relation between leptomeningeal ectopic lymphocytic aggregates and cortical pathology was first shown in the study of Serafini et al [6]. In the study by Magliozzi et al, a gradient of necroptosis and demyelination severity in the cortex under
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