Spinal Cord Atrophy in Multiple Sclerosis: A Systematic Review and Meta‐Analysis
Bibliographic record
Abstract
ABSTRACT BACKGROUND AND PURPOSE Spinal cord atrophy (SCA) is an important emerging outcome measure in multiple sclerosis (MS); however, there is limited consensus on the magnitude and rate of atrophy. The objective of this study was to synthesize the available data on measures of SCA in MS. METHODS Using published guidelines, relevant literature databases were searched between 1977 and 2017 for case‐control or cohort studies reporting a quantitative measure of SCA in MS patients. Random‐effects models pooled cross‐sectional measures and longitudinal rates of SCA in MS and healthy controls (HCs). Student's t ‐test assessed differences between pooled measures in patient subgroups. Heterogeneity was assessed using DerSimonian and Laird's Q ‐test and the I 2 ‐index. RESULTS A total of 1,465 studies were retrieved including 94 that met inclusion and exclusion criteria. Pooled estimates of mean cervical spinal cord (SC) cross‐sectional area (CSA) in all MS patients, relapsing‐remitting MS (RRMS), all progressive MS, secondary progressive MS (SPMS), primary‐progressive MS (PPMS), and HC were: 73.07 mm 2 (95% CI [71.52‐74.62]), 78.88 mm 2 (95% CI [76.92‐80.85]), 69.72 mm 2 (95% CI [67.96‐71.48]), 68.55 mm 2 (95% CI [65.43‐71.66]), 70.98 mm 2 (95% CI [68.78‐73.19]), and 80.87 mm 2 (95% C I [78.70‐83.04]), respectively. Pooled SC‐CSA was greater in HC versus MS ( P < .001) and RRMS versus progressive MS ( P < .001). SCA showed moderate correlations with global disability in cross‐sectional studies ( r ‐value with disability score range [−.75 to −.22]). In longitudinal studies, the pooled annual rate of SCA was 1.78%/year (95%CI [1.28‐2.27]). CONCLUSIONS The SC is atrophied in MS. The magnitude of SCA is greater in progressive versus relapsing forms and correlates with clinical disability. The pooled estimate of annual rate of SCA is greater than reported rates of brain atrophy in MS. These results demonstrate that SCA is highly relevant as an imaging outcome in MS clinical trials.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.030 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.028 |
| Bibliometrics | 0.007 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".