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Abstract #0489

Damage of Different CNS Compartments Contributes to Explain Multiple Sclerosis Disability Milestones: A Multicenter Study

Paola Valsasina1, Milagros Hidalgo de la Cruz1, Alessandro Meani1, Claudio Gobbi2,3, Antonio Gallo4, Chiara Zecca2,3, Alvino Bisecco4, Maria A. Rocca1,5,6, and Massimo Filippi1,5,6,7,8
1Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy, 2Multiple Sclerosis Center, Department of Neurology, Neurocenter of Southern Switzerland, Civic Hospital, Lugano, Switzerland, 3Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland, 4Department of Advanced Medical and Surgical Sciences, and 3T MRI Center, University of Campania “Luigi Vanvitelli”, Naples, Italy, 5Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy, 6Vita-Salute San Raffaele University, Milan, Italy, 7Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy, 8Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy

Here, we assessed damage of cortex, deep grey matter, cerebellum and cervical cord to determine their relative contributions to the main clinical disability (EDSS) milestones in a multicentre cohort of 198 multiple sclerosis (MS) patients. The main determinants of EDSS=3.0 were cervical cord and thalamic atrophy, and brain lesion burden. The EDSS=4.0 milestone was better explained by cortical atrophy, together with cord and cerebellar damage, while the only predictor of EDSS=6.0 was cervical cord damage. This study is shading light on the differential weight of inflammatory and neurodegenerative processes leading to disability accumulation across various MS disease phases.

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