African Americans experience disproportionate neurodegenerative changes in the medulla and upper cervical spinal cord in early multiple sclerosis.

•African American MS patients experience disproportionate neurodegenerative changes.•Reduced medulla-upper cervical spinal cord tissue compliance present in AA MS.•Increased rates of generalized atrophy present in AA MS patients.•Greater dorsal surface texture changes, than ventral, present in AA MS patients.