Observational studyThe Journal of clinical investigation2016
Persistent 7-tesla phase rim predicts poor outcome in new multiple sclerosis patient lesions.
Observational study in The Journal of clinical investigation, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 182 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Evaluation of Progression in Multiple Sclerosis by Magnetic Resonance Imaging (MRI)
Investigating Cortical Gray Matter Demyelination in Primary Progressive Multiple Sclerosis at 7 Tesla
Multiple Sclerosis Lesion Characterization on Ultra-high-field MRI: Comparative Pilot Study of 9.4 Vs 7 Vs 3 Tesla
Validation and Standardization of Paramagnetic Rim Lesion (PRL) Identification in Multiple Sclerosis Across MAGNIMS Centers - From Scientific Setting Towards Clinical Applicability
Who cites it
182 citing papers in PubMed, 5 syntheses or guidelines pooled it, 328 citations in OpenAlex.
- Iron accumulation in multiple sclerosis and implications for cognitive and clinical progression: a systematic review of advanced neuroimaging studies.Journal of neurology · 2026Pooled it
- Characterizing iron rim lesions in multiple sclerosis: a biomarker for disease activity and progression: a systematic review and meta-analysis.Neuroradiology · 2025Pooled it
- Associations between chronic active lesions and clinical outcomes in multiple sclerosis: A systematic literature review.Journal of managed care & specialty pharmacy · 2025Pooled it
- The prevalence of paramagnetic rim lesions in multiple sclerosis: A systematic review and meta-analysis.PloS one · 2021Pooled it
- Clinical and Paraclinical Biomarkers and the Hitches to Assess Conversion to Secondary Progressive Multiple Sclerosis: A Systematic Review.Frontiers in neurology · 2021Pooled it
- Ibudilast reduces slowly enlarging lesions in progressive multiple sclerosis.Multiple sclerosis (Houndmills, Basingstoke, England) · 2024Trial
- Safety and efficacy of tolebrutinib, an oral brain-penetrant BTK inhibitor, in relapsing multiple sclerosis: a phase 2b, randomised, double-blind, placebo-controlled trial.The Lancet. Neurology · 2021Trial
- Patterning Chronic Active Demyelination in Slowly Expanding/Evolving White Matter MS Lesions.AJNR. American journal of neuroradiology · 2020Trial
- Chronic white matter lesion activity predicts clinical progression in primary progressive multiple sclerosis.Brain : a journal of neurology · 2019Trial
- Serum Glial-Related Biomarkers Show Distinct Contributions to Radiologic and Clinical Outcomes in Early Multiple Sclerosis.Neurology(R) neuroimmunology & neuroinflammation · 2026Article
- Targeting progressive multiple sclerosis: Toward mechanism-informed precision medicine.Journal of internal medicine · 2026Review
- Foamy microglia link oxylipins to disease progression in multiple sclerosis.Nature neuroscience · 2026Article
- Tract-based χ-separation imaging differentiates multiple sclerosis from neuromyelitis optica spectrum disorder by mapping iron and myelin signatures.BMC medical imaging · 2026Article
- Depression as a Disease of White Matter Network Disruption: Learning From Multiple Sclerosis.Biological psychiatry · 2026Review
- Singular Value Decomposition-Based Coil Combination Improves the Accuracy and Noise-Robustness of Quantitative Susceptibility Maps.medRxiv : the preprint server for health sciences · 2026Article
- Transcriptional Heterogeneity of Oligodendrocytes: Molecular Basis of Diversity Across Development, Brain Regions, and Neurological Diseases.Neurology international · 2026Review
- Treatment Effects on Chronic Active Lesions in Multiple Sclerosis: Current Evidence and Future Perspectives.Neurology and therapy · 2026Review
- The hypoxia-inflammation cycle as a key mechanism of smoldering inflammation and progression in multiple sclerosis.Acta neuropathologica · 2026Review
- Diffusivity anisotropy signature of slowly expanding lesions predicts progression independent of relapse activity in multiple sclerosis.Journal of neurology, neurosurgery, and psychiatry · 2026Observational
- A HIF1A variant impacts long-term disability and smoldering inflammation in multiple sclerosis.Acta neuropathologica · 2026Article
122 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 1 institution in 1 country.
Funding
Abstract
backgroundIn some active multiple sclerosis (MS) lesions, a strong immune reaction at the lesion edge may contain growth and thereby isolate the lesion from the surrounding parenchyma. Our previous studies suggest that this process involves opening of the blood-brain barrier in capillaries at the lesion edge, seen on MRI as centripetal contrast enhancement and a colocalized phase rim. We hypothesized that using these features to characterize early lesion evolution will allow in vivo tracking of tissue degeneration and/or repair, thus improving the evaluation of potential therapies for chronic active lesions.
methodsCentripetally and centrifugally enhancing lesions were studied in 17 patients with MS using 7-tesla MRI. High-resolution, susceptibility-weighted, T1-weighted (before/after gadolinium), and dynamic contrast-enhanced scans were acquired at baseline and months 1, 3, 6, and 12. For each lesion, time evolution of the phase rim, lesion volume, and T1 hypointensity were assessed. In autopsies of 3 progressive MS cases, the histopathology of the phase rim was determined.
resultsIn centripetal lesions, a phase rim colocalized with initial contrast enhancement. In 12 of 22, this phase rim persisted after enhancement resolved. Compared with centripetal lesions with transient rim, those with persistent rim had less volume shrinkage and became more T1 hypointense between months 3 and 12. No centrifugal lesions developed phase rims at any time point. Pathologically, persistent rims corresponded to an iron-laden inflammatory myeloid cell population at the edge of chronic demyelinated lesions.
conclusionIn early lesion evolution, a persistent phase rim in lesions that shrink least and become more T1 hypointense over time suggests that the rim might mark failure of early lesion repair and/or irreversible tissue damage. In later stages of MS, phase rim lesions continue to smolder, exerting detrimental effects on affected brain tissue.
trial registrationNCT00001248.
fundingThe Intramural Research Program of NINDS supported this study.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.