The distribution of patients according to the disease duration revealed an increased prevalence of LMCE in patients with the disease duration over 20 years.
MS patients with LMCE showed significantly smaller normalized brain volume (1389.8 versus 1426.2, p = 0,0462) and white matter volume (658.1 versus 678.6, p = 0,0468) compared to LMCE-negative patients.
Analysis of data, adjusted for age, sex, and disease duration (ANCOVA), demonstrated a significant effect of LMCE on the cortex volume (p = 0.043, F = 2.529), total grey-matter volume (p = 0.043, F = 2.54), and total ventricular volume (p = 0.039, F = 2.605) and a trend for a significant effect on thalamic volume (p = 0.051, F = 2.428) (Table 3).
Recent studies have demonstrated that LMCE was associated with significant cortical atrophy and cortical demyelination [9, 11].
Our study demonstrated that most LMCE foci were supratentorial and located in proximity to large meningeal vessels.
No difference was revealed for IgG-OCB positivity according to the LMCE status.
It was hypothesized that LMCE is associated with greater brain atrophy, especially with grey matter and cortical atrophy, based on the research by Zivadinov et al.
The strength of the study was the 3D FLAIR MRI protocol with precontrast FLAIR acquisition that helped to exclude doubtful LMCE foci and a small slice thickness that helped to reveal even small areas of leptomeningeal enhancement.
LMCE is a feasible biomarker in multiple sclerosis with yet not fully determined significance.