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 Gobbi^2,3, Antonio Gallo⁴, Chiara Zecca^2,3, Alvino Bisecco⁴, Maria A. Rocca^1,5,6, and Massimo Filippi^1,5,6,7,8

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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