Spinal neurodegeneration is an important factor affecting disability progression in patients with primary progressive multiple sclerosis (PPMS).

Researchers from the Queen Square MS Centre in London, UK, are using advanced magnetic resonance imaging (MRI) techniques to study spinal cord integrity, as it has been associated with disability in patients with PPMS. This is important as there are few specific indicators of neurodegeneration in this type of MS.

Findings

The researchers found structural damage of neurons, demyelination, and chemical abnormalities in the cervical cord of early PPMS, in the absence of extensive spinal cord atrophy.

This suggests that early spinal neurodegeneration may underlie clinical impairment, and should be targeted in future clinical trials with neuroprotective drugs to prevent the development of progressive disability. Spinal cord abnormalities, investigated by MRI, could be used to predict clinical outcomes and treatment response in clinical trials in PPMS.

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