Longitudinal clinical study of patients with iron rim lesions in multiple sclerosis

Altokhis, Amjad I.; Hibbert, Aimee M.; Allen, Christopher M.; Mougin, Olivier; Alotaibi, Abdulmajeed; Lim, Su Yin; Constantinescu, Cris S.; Abdel-Fahim, Rasha; Evangelou, Nikos

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.

Citation

Altokhis, A. I., Hibbert, A. M., Allen, C. M., Mougin, O., Alotaibi, A., Lim, S. Y., Constantinescu, C. S., Abdel-Fahim, R., & Evangelou, N. (2022). Longitudinal clinical study of patients with iron rim lesions in multiple sclerosis. Multiple Sclerosis Journal, 28(14), 2202-2211. https://doi.org/10.1177/13524585221114750

• Journal Article Type: Article
• Acceptance Date: Jun 30, 2022
• Online Publication Date: Aug 24, 2022
• Publication Date: 2022-12
• Deposit Date: Jul 26, 2022
• Publicly Available Date: Aug 24, 2022
• Journal: Multiple Sclerosis Journal
• Print ISSN: 1352-4585
• Electronic ISSN: 1477-0970
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 28
• Issue: 14
• Pages: 2202-2211
• DOI: https://doi.org/10.1177/13524585221114750
• Keywords: Neurology (clinical); Neurology
• Public URL: https://nottingham-repository.worktribe.com/output/9401879
• Publisher URL: https://journals.sagepub.com/doi/full/10.1177/13524585221114750