Cervical spinal cord atrophy is an important MRI measure that correlates with progressive MS. We have previously shown that the cranio-caudal loss of cervical cord area correlates with the evolution in MS disease continuum. In this prospective study, in addition to age, we showed that thalamic volumes may correlate with cervical cord area measurements, possibly through a Wallerian degeneration mechanism, while total brain lesion volumes do not. Our findings suggest that spinal cord area measurements in MS is potentially an independent metric from lesion load measurements but can be complemented by thalamic volume measurements as imaging outcomes in clinical trials.
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