TY - JOUR
T1 - Relationship between paramagnetic rim lesions and slowly expanding lesions in multiple sclerosis
AU - Calvi, Alberto
AU - Clarke, Margareta A.
AU - Prados, Ferran
AU - Chard, Declan
AU - Ciccarelli, Olga
AU - Alberich, Manel
AU - Pareto, Deborah
AU - Rodríguez Barranco, Marta
AU - Sastre-Garriga, Jaume
AU - Tur, Carmen
AU - Rovira, Alex
AU - Barkhof, Frederik
N1 - Funding Information: C. Tur has received 2021 Merck’s Award for the Investigation in Multiple Sclerosis, Junior Leader La Caixa Fellowship in 2020, ECTRIMS Post-doctoral Research Fellowship in 2015; honoraria and support for travelling from Merck Serono, Sanofi, Roche, TEVA Pharmaceuticals, Novartis, Biogen, Bayer, Ismar Healthcare. Publisher Copyright: © The Author(s), 2022.
PY - 2023/3/1
Y1 - 2023/3/1
N2 - BACKGROUND: Magnetic resonance imaging (MRI) markers for chronic active lesions in MS include slowly expanding lesions (SELs) and paramagnetic rim lesions (PRLs). OBJECTIVES: To identify the relationship between SELs and PRLs in MS, and their association with disability. METHODS: 61 people with MS (pwMS) followed retrospectively with MRI including baseline susceptibility-weighted imaging, and longitudinal T1 and T2-weighted scans. SELs were computed using deformation field maps; PRLs were visually identified. Mixed-effects models assessed differences in Expanded Disability Status Scale (EDSS) score changes between the group defined by the presence of SELs and or PRLs. RESULTS: The median follow-up time was 3.2 years. At baseline, out of 1492 lesions, 616 were classified as SELs, and 80 as PRLs. 92% of patients had ⩾ 1 SEL, 56% had ⩾ 1 PRL, while both were found in 51%. SELs compared to non-SELs were more likely to also be PRLs (7% vs. 4%, p = 0.027). PRL counts positively correlated with SEL counts (ρ= 0.28, p = 0.03). SEL + PRL + patients had greater increases in EDSS over time (beta = 0.15/year, 95% confidence interval (0.04, 0.27), p = 0.009) than SEL+PRL-patients. CONCLUSION: SELs are more numerous than PRLs in pwMS. Compared with either SELs or PRLs found in isolation, their joint occurrence was associated with greater clinical progression.
AB - BACKGROUND: Magnetic resonance imaging (MRI) markers for chronic active lesions in MS include slowly expanding lesions (SELs) and paramagnetic rim lesions (PRLs). OBJECTIVES: To identify the relationship between SELs and PRLs in MS, and their association with disability. METHODS: 61 people with MS (pwMS) followed retrospectively with MRI including baseline susceptibility-weighted imaging, and longitudinal T1 and T2-weighted scans. SELs were computed using deformation field maps; PRLs were visually identified. Mixed-effects models assessed differences in Expanded Disability Status Scale (EDSS) score changes between the group defined by the presence of SELs and or PRLs. RESULTS: The median follow-up time was 3.2 years. At baseline, out of 1492 lesions, 616 were classified as SELs, and 80 as PRLs. 92% of patients had ⩾ 1 SEL, 56% had ⩾ 1 PRL, while both were found in 51%. SELs compared to non-SELs were more likely to also be PRLs (7% vs. 4%, p = 0.027). PRL counts positively correlated with SEL counts (ρ= 0.28, p = 0.03). SEL + PRL + patients had greater increases in EDSS over time (beta = 0.15/year, 95% confidence interval (0.04, 0.27), p = 0.009) than SEL+PRL-patients. CONCLUSION: SELs are more numerous than PRLs in pwMS. Compared with either SELs or PRLs found in isolation, their joint occurrence was associated with greater clinical progression.
KW - Chronic active lesions
KW - multiple sclerosis
KW - paramagnetic rim lesions (PRLs)
KW - slowly expanding lesions (SELs)
KW - susceptibility-weighted imaging (SWI)
KW - volumetric MRI
UR - http://www.scopus.com/inward/record.url?scp=85148964983&partnerID=8YFLogxK
U2 - https://doi.org/10.1177/13524585221141964
DO - https://doi.org/10.1177/13524585221141964
M3 - Article
C2 - 36515487
SN - 1352-4585
VL - 29
SP - 352
EP - 362
JO - Multiple sclerosis (Houndmills, Basingstoke, England)
JF - Multiple sclerosis (Houndmills, Basingstoke, England)
IS - 3
ER -