Higher prevalence of restless legs syndrome/Willis-Ekbom disease in multiple sclerosis patients is related to spinal cord lesions

Multiple sclerosis (MS) in Asian populations is often characterized by the selective involvement of the optic nerve (ON) and spinal cord (SP) (OSMS) in contrast to classic MS (CMS), where frequent lesions are observed in the cerebrum, cerebellum or brainstem. In Western countries, inflammatory demyelinating disease preferentially involving the ON and SP is called neuromyelitis optica (NMO). Recently, Lennon et al. discovered that NMO-IgG, shown to bind to aquaporin 4 (AQP4), could be a specific marker of NMO and also of Japanese OSMS whose clinical features were identical to NMO having long spinal cord lesions extending over three vertebral segments (LCL). To examine this antibody in larger populations of Japanese OSMS patients in order to know its epidemiological and clinical spectra, we established an immunohistochemical detection system for the anti-AQP4 antibody (AQP4-Ab) using the AQP4-transfected human embryonic kidney cell line (HEK-293) and confirmed AQP4-Ab positivity together with the immunohistochemical staining pattern of NMO-IgG in approximately 60% of Japanese OSMS patients with LCL. Patients with OSMS without LCL and those with CMS were negative for this antibody. Our results accorded with those of Lennon et al. suggest that Japanese OSMS with LCL may have an underlying pathogenesis in common with NMO. Multiple Sclerosis 2007; 13: 850—855. http://msj.sagepub.com

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MRI Spinal Cord Lesions in a Cohort of Multiple Sclerosis Patients in Saskatchewan, Canada

International Journal of MS Care ◽

10.7224/1537-2073.2019-081 ◽

2020 ◽

pp. 0000-0000

Author(s):

Aman Saini ◽

Kevin Bach ◽

Ilia Poliakov ◽

Katherine B. Knox ◽

Michael C. Levin

Keyword(s):

Multiple Sclerosis ◽

Spinal Cord ◽

Cervical Cord ◽

Spinal Cord Lesions ◽

Cross Sectional ◽

Demographic Profiles ◽

Disease Modifying Therapy ◽

Younger Age ◽

Magnetic Resonance Imaging Mri ◽

Multiple Sclerosis Patients

Abstract Background: Spinal cord lesions (SCLs) contribute to disability in multiple sclerosis (MS). There is a lack of data in Saskatchewan concerning SCLs and their association with disability levels in MS patients. The objectives of this study were to: identify clinical-demographic profiles of MS patients with respect to spinal cord magnetic resonance imaging (MRI) involvement; determine frequency of individuals with spinal cord MRI lesion(s) and; explore differences between MS patients with and without SCLs with respect to disability and disease modifying therapy (DMT) status. Methods: A monocentric, cross-sectional, retrospective review of prospectively collected data from 532 research consented patients seen at Saskatoon MS Clinic was performed. Data was collected from a database and electronic medical records. Descriptive statistics and logistic regression were conducted using SPSS. Results: 356 of 532 (66.9%) had SCLs. Of the 356 patients with a SCL, 180 (50.5%) had cervical cord lesions. Median Expanded Disability Status Scale (EDSS), ambulation and pyramidal scores of SCL patients were higher than non-SCL (NSCL) patients. SCL patients with EDSS ≥ 6 were younger than NSCL patients with EDSS ≥ 6 (P = .01). SCL patients were 55% less likely to have been on continuous DMT since diagnosis than NSCL patients (adjusted OR = 0.45, 95% CI = 0.25–0.81, P = .008). Conclusions: Prevalence and association with disability of SCLs in MS patients are comparable to existing literature. MS patients with SCLs have higher levels of disability and attain EDSS ≥6 at a younger age.

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