Multiple sclerosis (MS) slowly evolving lesions (SELs) are defined on MRI as contiguous regions of pre-existing lesions with constant and concentric local expansion on conventional T1-weighted and T2-weighted images. Myelin-related changes using myelin water fraction (MWF) and magnetization transfer ratio (MTR) in SELs and non-SELs were measured over 192 weeks in patients with relapsing MS. SELs showed reduced myelin measures at baseline compared to non-SELs. Furthermore, over the 4 years, only SELs, and not non-SELs, showed a significant mean decrease in MWF and increase in T1. Both results are indicative of progressive demyelination in this subgroup of chronic lesions.
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