Clinical relevance of paramagnetic rim lesion heterogeneity in multiple sclerosis.

Détails

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Etat: Public
Version: Final published version
Licence: CC BY-NC-ND 4.0
ID Serval
serval:BIB_2C5E9C390C11
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Clinical relevance of paramagnetic rim lesion heterogeneity in multiple sclerosis.
Périodique
Annals of clinical and translational neurology
Auteur⸱e⸱s
Stölting A., Vanden Bulcke C., Borrelli S., Bugli C., Du Pasquier R., van Pesch V., Maggi P.
ISSN
2328-9503 (Electronic)
ISSN-L
2328-9503
Statut éditorial
Publié
Date de publication
12/2024
Peer-reviewed
Oui
Volume
11
Numéro
12
Pages
3137-3151
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Previous studies reveal heterogeneity in terms of paramagnetic rim lesions (PRL) associated tissue damage. We investigated the physiopathology and clinical implications of this heterogeneity.
In 103 MS patients (72 relapsing and 31 progressive), brain lesions were manually segmented on 3T 3D-FLAIR and rim visibility was assessed with a visual confidence level score (VCLS) on 3D-EPI phase. Using T1 relaxation time maps, lesions were categorized in long-T1 and short-T1. Lesion age was calculated from time of first gadolinium enhancement (N = 84 lesions). Results on clinical scores were validated in an extended cohort of 167 patients using normalized T1w-MPRAGE lesion values.
Rim visibility (VCLS analysis) was associated with increasing lesional T1 (P/P <sub>FDR</sub> < 0.001). Of 1680 analyzed lesions, 427 were categorized as PRL. Long-T1 PRL were older than short-T1 PRL (average 0.8 vs. 2.0 years, P/P <sub>FDR</sub> = 0.005/0.008), and featured larger lesional volume (P/P <sub>FDR</sub> < 0.0001) and multi-shell diffusion-measured axonal damage (P/P <sub>FDR</sub> < 0.0001). The total volume of long-T1-PRL versus PRL showed 2× predictive power for both higher MS disability (EDSS; P/P <sub>FDR</sub> = 0.003/0.005 vs. P/P <sub>FDR</sub> = 0.042/0.057) and severity (MSSS; P/P <sub>FDR</sub> = 0.0006/0.001 vs. P/P <sub>FDR</sub> = 0.004/0.007). In random forest, having ≥1 long-T1-PRL versus ≥4 PRL showed 2-4× higher performance to predict a higher EDSS and MSSS. In the validation cohort, long-T1 PRL outperformed (~2×) PRL in predicting both EDSS and MSSS.
PRL show substantial heterogeneity in terms of intralesional tissue damage. More destructive, likely older, long-T1 PRL improve the association with MS clinical scales. This PRL heterogeneity characterization was replicated using standard T1w MRI, highlighting its potential for clinical translation.
Mots-clé
Humans, Female, Adult, Male, Middle Aged, Magnetic Resonance Imaging, Multiple Sclerosis/diagnostic imaging, Multiple Sclerosis/pathology, Multiple Sclerosis/physiopathology, Multiple Sclerosis, Relapsing-Remitting/diagnostic imaging, Multiple Sclerosis, Relapsing-Remitting/physiopathology, Multiple Sclerosis, Relapsing-Remitting/pathology, Multiple Sclerosis, Chronic Progressive/diagnostic imaging, Multiple Sclerosis, Chronic Progressive/physiopathology, Multiple Sclerosis, Chronic Progressive/pathology, Brain/diagnostic imaging, Brain/pathology, Clinical Relevance
Pubmed
Web of science
Open Access
Oui
Création de la notice
11/10/2024 14:13
Dernière modification de la notice
25/02/2025 8:10
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