Upper cervical spinal cord atrophy in MS: Sex, menopause, and neurodegeneration
Bibliographic record
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 (UCC brain ) was obtained. Impact of sex and menopause on UCC brain (adjusted for total intracranial volume) and its association with progression and disability, including MS functional composite (MSFC), were investigated. Results: UCC brain was smaller in pwMS ( n = 118, 51.4 ± 5.3 mm 2 ) than controls ( n = 118, 54.2 ± 4.4 mm 2 , 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), UCC brain was smaller in men (49.5 ± 5.9 mm 2 ) than women (51.6 ± 5.5 mm 2 , p = 0.001), postmenopausal women (49.4 ± 5.6 mm 2 ) than premenopausal women (52.9 ± 4.1 mm 2 , p < 0.001), and progressive (47.5 ± 5.6 mm 2 ) than relapsing MS (52.1 ± 5.2 mm 2 , p < 0.001). UCC brain 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: UCC brain , 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.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".