A research team from University College London looked at whether the level of damage caused by lesions to the spinal cord (referred to as cord lesion load in the rest of this article) is associated with disability in MS.
The team used a new MRI technique to better visualise and investigate spinal cord lesions. They used this on 120 people: 34 people with relapsing-remitting MS, 29 with secondary progressive, 29 with primary progressive and 28 controls.
Cord lesion load was significantly higher in patients with primary and secondary progressive MS than in patients with relapsing-remitting MS.
The researchers studied the total cord lesion load and cervical spinal cord atrophy.
They showed that spinal cord atrophy and lesion load measurements did not significantly differ between secondary progressive and primary progressive MS, but were higher than in relapsing-remitting patients. Furthermore, both spinal cord atrophy and lesion load were independently associated with disability.
This study shows that it is plausible that cord lesion load and spinal cord atrophy contribute to disability in people with progressive MS.
Longitudinal studies (studies that observe people with MS over many years) are required to understand the evolution of cord lesion load in MS, and to consider its potential as an outcome measure in clinical trials.