When myelin damage occurs in places with tightly packed nerve fibres, such as the spinal cord, the risk of disability increases. But research is starting to show that lesions can appear in this area without worsening or new MS symptoms.
As yet, a firm link between the asymptomatic loss of myelin in the spinal cord and increasing disability has not been proven. But the findings suggest that perhaps patients with clinically stable MS should be monitored with MRI scans of the spine to check for asymptomatic progression.
A previous study found that finding spinal lesions in a patient between one and three years after MS symptoms developed correlated with higher Expanded Disability Status Scale scores 15 years later.
Source: MS-UK 10 February 2021