Longitudinal clinical study of patients with iron rim lesions in multiple sclerosis. (December 2022)

• Record Type: Journal Article
• Authors: Altokhis, Amjad I; Hibbert, Aimee M; Allen, Christopher M; Mougin, Olivier; Alotaibi, Abdulmajeed; Lim, Su-Yin; Constantinescu, Cris S; Abdel-Fahim, Rasha; Evangelou, Nikos
• Is Part Of: Multiple sclerosis. Volume 28:Number 14(2022)
• Page Start: 2202
• Page End: 2211
• Publication Date: 2022-12
• Subjects: Multiple sclerosis (MS) -- magnetic resonance imaging (MRI) -- white matter lesion (WML) -- iron rim lesion (IRL) -- biomarkers; Central nervous system -- Diseases -- Periodicals; Myelin sheath -- Diseases -- Periodicals; Inflammation -- Periodicals; Multiple sclerosis -- Periodicals; Central Nervous System Diseases -- Periodicals; Demyelinating Diseases -- Periodicals; Inflammation -- Periodicals; Multiple Sclerosis -- Periodicals; Système nerveux central -- Maladies -- Périodiques; Gaine de myéline -- Maladies -- Périodiques; Inflammation (Pathologie) -- Périodiques; Sclérose en plaques -- Périodiques; Electronic journals; 616.834005
• DOI: 10.1177/13524585221114750
• Languages: English
• ISSNs: 1352-4585

Abstract

Background: Iron rims (IRs) surrounding white matter lesions (WMLs) are suggested to predict a more severe disease course. Only small longitudinal cohorts of patients with and without iron rim lesions (IRLs) have been reported so far. Objective: To assess whether the presence and number of IRLs in patients with clinically isolated syndrome (CIS) and multiple sclerosis (MS) are associated with long-term disability or progressive disease. Methods: Ninety-one CIS/MS patients were recruited between 2008 and 2013 and scanned with 7 T magnetic resonance imaging (MRI). Expanded Disability Status Scale (EDSS) was used to calculate Age-related Multiple Sclerosis Severity Score (ARMSS) at the time of scan and at the latest clinical follow-up after 9 years. WMLs were assessed for the presence of IRL using Susceptibility weighted imaging (SWI)-filtered phase images. Results: In all, 132 IRLs were detected in 42 patients (46%); 9% of WMLs had IRs; 54% of the cohort had no rims, 30% had 1–3 rims and 16% had ⩾4. Patients with IRL had a higher EDSS and ARMSS. Presence of IRL was also a predictor of long-term disability, especially in patients with ⩾4 IRLs. IRLs have a greater impact on disability compared to the WML number and volume. Conclusion: The presence and number of perilesional IR on MRI hold prognostic value for long-term clinical disability in MS.