MS Frontiers 2022 | The relationship between slowly expanding lesions and paramagnetic rim lesions in multiple sclerosis

Alberto Calvi, MD, PhD Candidate, UCL Queen Square Institute of Neurology, Barts Health NHS Trust, London, UK, explains the rationale behind an investigation into MRI markers of chronic active lesions in multiple sclerosis (MS). These lesions are important in driving disability progression, hence understanding their clinical value and applicability was of interest. Slowly expanding lesions (SELs) and paramagnetic rim lesions (PRLs) have both been shown to contribute to clinical worsening but have never been studied in combination. Dr Calvi’s work in 61 subjects found that there was an association between these two markers, whereby there was a higher percentage of PRLs was found in the subgroup of patients with SELs, compared to those without. Additionally, there was a higher total lesion load and worse prediction for clinical outcomes in patients that had a combination of both markers. SELs and PRLs together predicted a higher EDSS at follow-up. This was an initial pilot analysis; therefore, more knowledge of these markers is important to understand the biology behind them. This interview took place at the MS Frontiers 2022 congress in Swansea, UK.