We describe the spatial distribution of multiple sclerosis (MS) lesions in the corticospinal tracts (CST), from the cortex to the lower cervical cord, using an open-source automated pipeline. We confirm the high frequency of CST focal damage in MS patients from the first year of relapsing-remitting MS and identify areas of predilection for MS lesions along the CST in the cervical spinal cord. At baseline, no significant correlation was observed between brain or spinal cord CST lesion volume fraction and physical disability scores. However, the baseline spinal cord CST lesion volume fraction correlated with the EDSS at 2 years.
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