Longitudinal clinical study of patients with white matter iron rims lesions in multiple sclerosis. Issue 9 (12th August 2022)

• Record Type: Journal Article
• Authors: Altokhis, Amjad; Hibbert, Aimee; Allen, Christopher; Mougin, Olivier; Alotaibi, Abdulmajeed; Lim, Su-Yin; Constantinescu, Cris; Abdel-Fahim, Rasha; Evangelou, Nikos
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 93:Issue 9(2022)
• Page Start: e2
• Publication Date: 2022-08-12
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2022-abn2.27
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Introduction: Identifying accurate prognostic imaging biomarkers in multiple sclerosis (MS) is crucial. Iron rims (IR) surrounding white matter lesions (WML) are suggested to predict a more severe disease course. Only small longitudinal cohorts of patients with and without IRL have been reported so far. Objective: To assess if the presence and number of IRL in patients with CIS and MS are associated with worse long-term clinical disability. Methods: Ninety-one CIS/MS patients were recruited between 2008 and 2013 and scanned with 7T MRI. Age-Related Multiple Sclerosis Score (ARMSS), a validated measure of disease severity, was calculated for patients at the time of scan and at the latest clinical follow-up after 9 years. WMLs were assessed for the presence of IRL using SWI-filtered phase images. Results: 132 IRLs were detected in 42 patients (46%). 9% of WMLs had IR. 54% of the cohort had no rims, 30% had 1-3 rims and 16% had ≥4. Patients with IRL at baseline had a higher EDSS and ARMSS. Presence of IRL was also a predictor of long-term disability especially in those patients with ≥4 IRL. The effect of IRL on disability was greater than the baseline WML numbers, another known prognostic biomarker. Conclusion: The presence and number of perilesional IR at a baseline scan hold prognostic value for long term clinical disability in MS.