Spine and Brain Signs That Predict MS Worsening

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Key Takeaway

Spinal cord shrinkage and brain cortex thinning best predict disability and progression in MS, and blood tests and advanced MRI add helpful, independent information.

What They Found

Researchers looked at brain and spine scans plus blood tests from people with MS to see which measures best matched disability, thinking problems, and worsening disease. The amount of spinal cord shrinkage (atrophy) was the strongest link to how disabled someone was and to a type of worsening that happens without relapses. Thinning of the brain’s outer layer (cortex) and loss in deep brain structures also predicted worse outcomes, especially for thinking and overall disease severity. Simple blood tests that measure nerve damage (sNfL) and support-cell damage (sGFAP) added useful information beyond the scans, meaning they show a different part of the disease. Advanced MRI measurements of tissue health gave extra, separate clues too, so combining scan and blood markers worked better than any single test alone.

Who Should Care and Why

People with MS should care because these findings point to tests that may help track and predict disability and silent progression, which affects daily life like walking, balance, or thinking. Caregivers can use this information to advocate for more complete testing (spine MRI plus brain MRI and blood tests) when talking with doctors, especially if a loved one seems to worsen without clear relapses. Neurologists and MS clinics benefit because combining spinal MRI, brain MRI, and blood markers can give a clearer picture of disease course and help guide treatment timing—like checking the oil, tires, and engine to judge a car’s health rather than looking at just one part. People worried about thinking problems (memory or attention) should note that cortical and deep brain changes were tied to cognitive issues, so targeted monitoring may help start supports earlier. Patients with progressive symptoms or few relapses might especially benefit, since these measures were good at predicting progression that happens without relapses.

Important Considerations

This study pooled data from two groups and used machine learning to pick important tests, but that doesn't prove cause—these measurements are associated with worse outcomes, not necessarily the direct reason for them. The cohorts and tests used varied (one used advanced MRI methods, the other used standard MRI), so results may differ between clinics that use different scanners or tests; not every center can measure all these things the same way. While blood tests and MRIs add useful information, they are not perfect predictors—doctors will still use symptoms, exam findings, and other tests to make decisions.

Categories:

MS Diagnostics MS Progression Clinical Trials

Article Topics:

MRIMultiple SclerosisProgression Independent of Relapse ActivityQuantitative MRISerum Glial Fibrillary Acidic ProteinSerum Neurofilament Light ChainSpinal Cord Atrophy

Whether you’ve recently been diagnosed with Multiple Sclerosis (MS) or are seeking to broaden your understanding of this complex, neurodegenerative disease, navigating the latest research can feel overwhelming. Studies published in respected medical journals like Advanced science (Weinheim, Baden-Wurttemberg, Germany) often range from early-stage, exploratory work to advanced clinical trials. These evidence-based findings help shape new disease-modifying therapies, guide symptom management techniques, and deepen our knowledge of MS progression.

However, not all research is created equal. Some clinical research studies may have smaller sample sizes, evolving methodologies, or limitations that warrant careful interpretation. For a more comprehensive, accurate understanding, we recommend reviewing the original source material—accessible via the More Details section above—and consulting with healthcare professionals who specialize in MS care.

By presenting a wide range of MS-focused studies—spanning cutting-edge treatments, emerging therapies, and established best practices—we aim to empower patients, caregivers, and clinicians to stay informed and make well-informed decisions when managing Multiple Sclerosis.

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