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Baseline Cortical Damage Predicts Onset of Secondary Progressive Multiple Sclerosis

June 8, 2018

In patients with multiple sclerosis (MS), extensive cortical damage at onset is associated with florid inflammatory clinical activity and increases the risk for rapid occurrence of the progressive phase, according to results published in Neurology.

Risk factors that can help identify high-risk patients include age at onset, the number of early attacks, and the extent of baseline focal cortical damage. These patients may benefit from more active therapy.

The study included participants with relapsing-remitting MS. The researchers assessed the number of cortical lesions, the number of white matter lesions, and cortical thickness at baseline and after 7.9 mean years of follow-up.

In 6.1 mean years, 27% of participants converted to secondary progressive MS (SPMS).

A larger number of cortical lesions at baseline predicted a higher risk for SPMS and shorter latency to progression.

Participants with 3 early relapses had a larger volume of white matter and cortical lesions at onset, accrued more cortical lesions, experienced more severe cortical atrophy over time, and entered the SPMS phase more rapidly compared with participants with 1 or 2 early relapses.

Via Neurology Advisor