Paramagnetic rim lesions predict greater long-term relapse rates and clinical progression over 10 years.

BACKGROUND

Paramagnetic rim lesions (PRLs) have been linked to higher clinical disease severity and relapse frequency. However, it remains unclear whether PRLs predict future, long-term disease progression.

OBJECTIVES

The study aimed to assess whether baseline PRLs were associated with subsequent long-term (10 years) Expanded Disability Status Scale (EDSS) increase and relapse frequency and, if so, whether PRL-associated EDSS increase was mediated by relapse.

METHODS

This retrospective analysis included 172 people with multiple sclerosis (pwMS) with 1868 yearly clinical visits over a mean follow-up time of 10.2 years. 3T magnetic resonance imaging (MRI) was acquired at baseline and PRLs were assessed on quantitative susceptibility mapping (QSM) images. The associations between PRLs, relapse, and rate of EDSS change were assessed using linear models.

RESULTS

PRL+ pwMS had greater overall annual relapse rate (β = 0.068;

CONCLUSION

PRLs are a marker of aggressive ongoing disease inflammatory activity, including more frequent future clinical relapses and greater long-term, relapse-independent disability progression.

Déclaration de conflit d'intérêts

Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: J.A.R., M.M., T.W., F.Sa., A.B., D.J., N.B., and F.Sc. have no conflicts of interest to disclose. M.G.D. has received personal compensation from Bristol Myers Squibb, Novartis, EMD Serono, and Keystone Heart, and financial support for research activities from Bristol Myers Squibb, Novartis, Mapi Pharma, Keystone Heart, Protembis, and V-WAVE Medical. B.W.G. has participated in speakers’ bureaus for, served as a consultant for, and has received research support from Biogen, EMD Serono, Novartis, Genentech, Celgene/Bristol Myers Squibb, Sanofi & Genzyme, Janssen, Horizon, Bayer, and Labcorp. Dr. B.W.G. also serves on the editorial board for BMJ Neurology, Children, CNS Drugs, MS International, and Frontiers Epidemiology. R.Z. has received personal compensation from Bristol Myers Squibb, EMD Serono, Sanofi, and Novartis for speaking and consultant fees; he received financial support for research activities from Sanofi, Novartis, Bristol Myers Squibb, Mapi Pharma, Keystone Heart, Protembis, and V-WAVE Medical.