Paramagnetic rim lesions are associated with greater incidence of relapse and worse cognitive recovery following relapse

Mult Scler. 2023 Jul;29(8):1033-1038. doi: 10.1177/13524585231169466. Epub 2023 May 9.

Abstract

Background: Paramagnetic rim lesions (PRL) may be linked to relapse risk of people with relapsing-remitting multiple sclerosis (pwRRMS).

Objective: To determine the relationship between presence of PRL lesions and cognitive recovery after relapse.

Methods: PRL load was compared between acutely relapsing pwRRMS and matched stable pwRRMS controls (each group n = 21). In addition, cognitive recovery was compared between acutely relapsing pwRRMS with at least one PRL (PRL+) and those without any PRL (PRL-).

Results: Acutely relapsing pwRRMS had significantly greater prevalence and number of PRL (p = 0.004 and p = 0.003) compared with stable controls. These findings remained significant after adjusting for global neuroinflammatory burden (enhancing and non-enhancing lesions). In addition, acutely relapsing PRL + pwRRMS (n = 10) had worse recovery of verbal memory following relapse compared with acutely relapsing PRL - pwRRMS (n = 7; p = 0.027).

Conclusion: These findings may partially explain previously suggested associations between presence of PRL with more severe disease course.

Keywords: Paramagnetic rim lesion; cognitive recovery; multiple sclerosis; quantitative susceptibility mapping (QSM); relapse; susceptibility weighted imaging (SWI).

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Brain / pathology
  • Chronic Disease
  • Cognition
  • Humans
  • Incidence
  • Magnetic Resonance Imaging
  • Multiple Sclerosis*
  • Multiple Sclerosis, Relapsing-Remitting* / pathology
  • Recurrence