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| Item Type: | Article |
|---|---|
| Title: | The presence of a paramagnetic phase rim in multiple sclerosis is linked to lesion age: an exploratory study |
| Creators Name: | Klistorner, Samuel, Usnich, Tatiana, Clarke, Margareta A., Pareto, Deborah, Rovira, Àlex, Paul, Friedemann, Barnett, Michael and Klistorner, Alexander |
| Abstract: | BACKGROUND: In relapsing-remitting multiple sclerosis (RRMS), smouldering inflammation at the rims of chronic active lesions is increasingly recognised as a key driver of disease progression. Paramagnetic rim lesions (PRLs), detected using susceptibility-weighted imaging, have emerged as a potential biomarker of this chronic inflammatory activity. However, their clinical relevance and relationship to lesion-specific features such as size and age remain poorly understood. OBJECTIVE: To investigate the association between PRL presence and clinical/radiological measures of disease progression, and to explore how PRLs relate to lesion size and age. METHODS: A retrospective study of 60 RRMS patients with over 5 years of magnetic resonance imaging data was conducted using susceptibility-weighted angiography. Lesions larger than 100 mm(3) were analysed. RESULTS: PRLs were present in 48% of patients and represented 13% of lesions. PRLs were significantly larger and more structurally damaged, with volume correlating with EDSS change and brain atrophy. All lesions formed within 5 years of imaging were PRLs. This finding was validated in two independent international cohorts. Moreover, the proportion of rim-positive lesions decreased as lesion age increased. CONCLUSION: PRLs are closely linked to lesion age and early development, supporting their role as a dynamic biomarker of lesion activity in multiple sclerosis. |
| Keywords: | Chronic Active Lesions, Magnetic Resonance Imaging Biomarkers, Lesion Evolution, Iron Deposition, Susceptibility-Weighted Images, Rim Lesions |
| Source: | Multiple Sclerosis Journal Experimental Translational and Clinical |
| ISSN: | 2055-2173 |
| Publisher: | Sage Publications |
| Volume: | 11 |
| Number: | 3 |
| Page Range: | 1-11 |
| Date: | September 2025 |
| Official Publication: | https://doi.org/10.1177/20552173251378788 |
| PubMed: | View item in PubMed |
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