Evidence map›Paper›PMID 35027474›Full record

Trial reportNeurology(R) neuroimmunology & neuroinflammation2022

Central Vein Sign Profile of Newly Developing Lesions in Multiple Sclerosis: A 3-Year Longitudinal Study.

Omar Al-Louzi, Vijay Letchuman, Sargis Manukyan, Erin S Beck, Snehashis Roy, Joan Ohayon, Dzung L Pham, Irene Cortese, Pascal Sati, Daniel S Reich

Registry-linked trialOpen access · goldAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neurology(R) neuroimmunology & neuroinflammation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00001248 (Evaluation of Progression in Multiple Sclerosis by Magnetic Resonance Imaging), which is not on this map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
4.5field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT00001248 recruitingnot on this map

Evaluation of Progression in Multiple Sclerosis by Magnetic Resonance Imaging (MRI)

TypeobservationalSponsorNational Institute of Neurological Disorders and Stroke (NINDS)Ran1992Enrolled3,750ConditionsMultiple Sclerosis
3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 34 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Omar Al-LouziFrom the Translational Neuroradiology Section (O.A.-L., V.L., S.M., E.S.B., P.S., D.S.R.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Department of Neurology (O.A.-L., P.S.), Cedars-Sinai Medical Center, Los Angeles, CA; Section on Neural Function (S.R.), National Institute of Mental Health, NIH, Bethesda, MD; Neuroimmunology Clinic (J.O., I.C.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; and Center for Neuroscience and Regenerative Medicine (D.L.P.), the Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD.ORCID 0000-0003-2260-5660
Vijay LetchumanFrom the Translational Neuroradiology Section (O.A.-L., V.L., S.M., E.S.B., P.S., D.S.R.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Department of Neurology (O.A.-L., P.S.), Cedars-Sinai Medical Center, Los Angeles, CA; Section on Neural Function (S.R.), National Institute of Mental Health, NIH, Bethesda, MD; Neuroimmunology Clinic (J.O., I.C.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; and Center for Neuroscience and Regenerative Medicine (D.L.P.), the Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD.ORCID 0000-0001-6594-596X
Sargis ManukyanFrom the Translational Neuroradiology Section (O.A.-L., V.L., S.M., E.S.B., P.S., D.S.R.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Department of Neurology (O.A.-L., P.S.), Cedars-Sinai Medical Center, Los Angeles, CA; Section on Neural Function (S.R.), National Institute of Mental Health, NIH, Bethesda, MD; Neuroimmunology Clinic (J.O., I.C.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; and Center for Neuroscience and Regenerative Medicine (D.L.P.), the Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD.
Erin S BeckFrom the Translational Neuroradiology Section (O.A.-L., V.L., S.M., E.S.B., P.S., D.S.R.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Department of Neurology (O.A.-L., P.S.), Cedars-Sinai Medical Center, Los Angeles, CA; Section on Neural Function (S.R.), National Institute of Mental Health, NIH, Bethesda, MD; Neuroimmunology Clinic (J.O., I.C.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; and Center for Neuroscience and Regenerative Medicine (D.L.P.), the Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD.ORCID 0000-0001-7839-7958
Snehashis RoyFrom the Translational Neuroradiology Section (O.A.-L., V.L., S.M., E.S.B., P.S., D.S.R.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Department of Neurology (O.A.-L., P.S.), Cedars-Sinai Medical Center, Los Angeles, CA; Section on Neural Function (S.R.), National Institute of Mental Health, NIH, Bethesda, MD; Neuroimmunology Clinic (J.O., I.C.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; and Center for Neuroscience and Regenerative Medicine (D.L.P.), the Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD.ORCID 0000-0002-7997-3993
Joan OhayonFrom the Translational Neuroradiology Section (O.A.-L., V.L., S.M., E.S.B., P.S., D.S.R.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Department of Neurology (O.A.-L., P.S.), Cedars-Sinai Medical Center, Los Angeles, CA; Section on Neural Function (S.R.), National Institute of Mental Health, NIH, Bethesda, MD; Neuroimmunology Clinic (J.O., I.C.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; and Center for Neuroscience and Regenerative Medicine (D.L.P.), the Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD.
Dzung L PhamFrom the Translational Neuroradiology Section (O.A.-L., V.L., S.M., E.S.B., P.S., D.S.R.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Department of Neurology (O.A.-L., P.S.), Cedars-Sinai Medical Center, Los Angeles, CA; Section on Neural Function (S.R.), National Institute of Mental Health, NIH, Bethesda, MD; Neuroimmunology Clinic (J.O., I.C.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; and Center for Neuroscience and Regenerative Medicine (D.L.P.), the Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD.ORCID 0000-0003-0053-2034
Irene CorteseFrom the Translational Neuroradiology Section (O.A.-L., V.L., S.M., E.S.B., P.S., D.S.R.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Department of Neurology (O.A.-L., P.S.), Cedars-Sinai Medical Center, Los Angeles, CA; Section on Neural Function (S.R.), National Institute of Mental Health, NIH, Bethesda, MD; Neuroimmunology Clinic (J.O., I.C.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; and Center for Neuroscience and Regenerative Medicine (D.L.P.), the Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD.
Pascal SatiFrom the Translational Neuroradiology Section (O.A.-L., V.L., S.M., E.S.B., P.S., D.S.R.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Department of Neurology (O.A.-L., P.S.), Cedars-Sinai Medical Center, Los Angeles, CA; Section on Neural Function (S.R.), National Institute of Mental Health, NIH, Bethesda, MD; Neuroimmunology Clinic (J.O., I.C.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; and Center for Neuroscience and Regenerative Medicine (D.L.P.), the Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD.ORCID 0000-0002-6763-0125
Daniel S ReichFrom the Translational Neuroradiology Section (O.A.-L., V.L., S.M., E.S.B., P.S., D.S.R.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; Department of Neurology (O.A.-L., P.S.), Cedars-Sinai Medical Center, Los Angeles, CA; Section on Neural Function (S.R.), National Institute of Mental Health, NIH, Bethesda, MD; Neuroimmunology Clinic (J.O., I.C.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; and Center for Neuroscience and Regenerative Medicine (D.L.P.), the Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD. daniel.reich@nih.gov.ORCID 0000-0002-2628-4334
Henry M. Jackson Foundation · US

Funding

Multimodal MRI in Multiple SclerosisZIANS003119 · NINDS · NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE · PI REICH, DANIEL · 2010 to 2025
$53.4M
6 · The paper itself

Abstract

BACKGROUND AND

objectivesThe central vein sign (CVS), a central linear hypointensity within lesions on T2*-weighted imaging, has been established as a sensitive and specific biomarker for the diagnosis of multiple sclerosis (MS). However, the CVS has not yet been comprehensively studied in newly developing MS lesions. We aimed to identify the CVS profiles of new white matter lesions in patients with MS followed over time and investigate demographic and clinical risk factors associated with new CVS+ or CVS- lesion development.

methodsIn this retrospective longitudinal cohort study, adults from the NIH MS Natural History Study were considered for inclusion. Participants with new T2 or enhancing lesions were identified through review of the radiology report and/or longitudinal subtraction imaging. Each new lesion was evaluated for the CVS. Clinical characteristics were identified through chart review.

resultsA total of 153 adults (95 relapsing-remitting MS, 27 secondary progressive MS, 16 primary progressive MS, 5 clinically isolated syndrome, and 10 healthy; 67% female) were included. Of this cohort, 96 had at least 1 new T2 or contrast-enhancing lesion during median 3.1 years (Q1-Q3: 0.7-6.3) of follow-up; lesions eligible for CVS evaluation were found in 62 (65%). Of 233 new CVS-eligible lesions, 159 (68%) were CVS+, with 30 (48%) individuals having only CVS+, 12 (19%) only CVS-, and 20 (32%) both CVS+ and CVS- lesions. In gadolinium-enhancing (Gd+) lesions, the CVS+ percentage increased from 102/152 (67%) at the first time point where the lesion was observed, to 92/114 (82%) after a median follow-up of 2.8 years. Younger age (OR = 0.5 per 10-year increase, 95% CI = 0.3-0.8) and higher CVS+ percentage at baseline (OR = 1.4 per 10% increase, 95% CI = 1.1-1.9) were associated with increased likelihood of new CVS+ lesion development. DISCUSSION: In a cohort of adults with MS followed over a median duration of 3 years, most newly developing T2 or enhancing lesions were CVS+ (68%), and nearly half (48%) developed new CVS+ lesions only. Importantly, the effects of edema and T2 signal changes can obscure small veins in Gd+ lesions; therefore, caution and follow-up is necessary when determining their CVS status. TRIAL REGISTRATION INFORMATION: Clinical trial registration number NCT00001248. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that younger age and higher CVS+ percentage at baseline are associated with new CVS+ lesion development.

Indexed as

Disease ProgressionAdultCerebral VeinsFemaleHumansLongitudinal StudiesMagnetic Resonance ImagingMaleMiddle AgedMultiple SclerosisRetrospective StudiesWhite Matter

Identifiers

PMID35027474
PMCPMC8759076
OpenAlexW4205504518

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.