Spinal Cord Lesions and Brain Grey Matter Atrophy Predict 5-Year Disease Worsening in Multiple Sclerosis: A Multicentre Study

Aim of this study was to evaluate the independent role of brain and cervical cord damage in predicting 5-year clinical disability worsening in a multicentre cohort of multiple sclerosis patients. Results showed that cortical atrophy and spinal cord damage, together with baseline disability and progressive disease phenotype, independently predicted 5-year disability worsening (C-index=0.81). Older age, higher clinical disability and cord lesion number independently predicted conversion to a progressive disease phenotype (C-index=0.91). Focal spinal cord lesions and cortical atrophy had also a role in predicting clinically-relevant disability milestones at 5 years.