Language

English

Publication Date

3-1-2025

Journal

Multiple Sclerosis Journal

DOI

10.1177/13524585241311441

PMID

39825669

PMCID

PMC11919563

PubMedCentral® Posted Date

3-19-2025

PubMedCentral® Full Text Version

Author MSS

Abstract

Background: Spinal cord (SC) atrophy is a key imaging biomarker of progressive multiple sclerosis (MS). Progressive MS is more common in men and postmenopausal women.

Objective: Investigate the impact of sex and menopause on SC measurements in persons with MS (pwMS).

Methods: In pwMS and age- and sex-matched controls, upper cervical SC area from brain MRI (UCCbrain) was obtained. Impact of sex and menopause on UCCbrain (adjusted for total intracranial volume) and its association with progression and disability, including MS functional composite (MSFC), were investigated.

Results: UCCbrain was smaller in pwMS (n = 118, 51.4 ± 5.3 mm2) than controls (n = 118, 54.2 ± 4.4 mm2, p < 0.001) and inversely correlated with older age in pwMS (r = -0.24, p = 0.010) but not in controls (r = -0.025, p = 0.786). In 173 pwMS (413 brain MRIs), UCCbrain was smaller in men (49.5 ± 5.9 mm2) than women (51.6 ± 5.5 mm2, p = 0.001), postmenopausal women (49.4 ± 5.6 mm2) than premenopausal women (52.9 ± 4.1 mm2, p < 0.001), and progressive (47.5 ± 5.6 mm2) than relapsing MS (52.1 ± 5.2 mm2, p < 0.001). UCCbrain also correlated with disease duration (r = -0.39, p < 0.001), 9-hole peg test (r = -0.26, p = 0.005), and severe ambulatory disability (Expanded Disability Status Scale ⩾6) (r = -0.27, p < 0.001).

Conclusion: UCCbrain, a biomarker of progressive MS, is inversely associated with age, disease duration, male sex, and menopause, highlighting the potential impact of sex and hormones on neurodegeneration in MS.

Keywords

Humans, Female, Male, Middle Aged, Atrophy, Adult, Magnetic Resonance Imaging, Menopause, Sex Factors, Cervical Cord, Multiple Sclerosis, Multiple Sclerosis, Chronic Progressive, Disease Progression, Aged, multiple sclerosis, upper cervical spinal cord, age, sex, menopause, progression

Published Open-Access

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