Abstract #1050

Multiparametric Quantitative MRI Shows Enhanced Degeneration in Paramagnetic Rim Lesions and Their Perilesional Tissue in Multiple Sclerosis

Alessandro Cagol^1,2,3,4, Mario Ocampo-Pineda^1,2,3, Batuhan Ayci^1,5, Pascal Benkert⁶, Po-Jui Lu^1,2,3, Matthias Weigel^1,2,3,7, Lester Melie-Garcia^1,2,3, Xinjie Chen^1,2,3, Antoine Lutti⁸, Thanh D. Nguyen⁹, Yi Wang⁹, Jongho Lee¹⁰, Jens Kuhle^2,3, Ludwig Kappos^1,2,3, Maria Pia Sormani⁴, and Cristina Granziera^1,2,3

¹Translational Imaging in Neurology (ThINk) Basel, Department of Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland, ²Department of Neurology, University Hospital Basel, Basel, Switzerland, ³Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland, ⁴Department of Health Sciences, University of Genova, Genova, Italy, ⁵Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey, ⁶Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland, ⁷Division of Radiological Physics, Department of Radiology, University Hospital Basel, Basel, Switzerland, ⁸Laboratory for Research in Neuroimaging, Department of Clinical Neuroscience, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland, ⁹Department of Radiology, Weill Cornell Medical College, New York, NY, United States, ¹⁰Laboratory for Imaging Science and Technology, Department of Electrical and Computer Engineering, Seoul National University, Seoul, Korea, Republic of

Synopsis

Keywords: Multiple Sclerosis, Multiple Sclerosis, Paramagnetic rim lesions; quantitative MRI

Motivation: Paramagnetic rim lesions (PRLs), a subset of chronic active lesions identifiable through susceptibility-based imaging, are linked to insidious disease progression in multiple sclerosis (MS). However, data on local microstructural changes in PRLs remain limited.

Goal(s): To comprehensively characterize pathological alterations within PRLs and the surrounding perilesional tissue.

Approach: Employing multiparametric quantitative 3T MRI on 175 people with MS, we obtained contrasts sensitive to tissue microstructural damage.

Results: PRLs exhibited more pronounced pathological alterations compared to other white matter lesions, displaying enhanced demyelination, neuro-axonal loss, and iron accumulation. Remarkably, these alterations extended into the perilesional tissue appearing normal on conventional MRI.

Impact: In people with multiple sclerosis, paramagnetic rim lesions (PRLs) exhibit pronounced microstructural quantitative MRI alterations. This strengthens PRLs as reliable biomarkers for lesions with smoldering degenerative activity, and offers potential insights into their association with a more severe disease course.

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