ArticleMultiple sclerosis (Houndmills, Basingstoke, England)2025
Presence of slowly expanding lesions in multiple sclerosis predicts progressive demyelination within lesions and normal-appearing tissue over time.
Article in Multiple sclerosis (Houndmills, Basingstoke, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Treatment Effects on Chronic Active Lesions in Multiple Sclerosis: Current Evidence and Future Perspectives.Neurology and therapy · 2026Review
- Slowly Expanding Lesions in Multiple Sclerosis: A Systematic Review and Meta-Analysis.NeuroSci · 2026Review
- Longitudinal myelin MR imaging in patients with multiple sclerosis: a narrative review.Journal of neurology · 2026Review
- Smoldering neuroinflammation in progressive multiple sclerosis: mechanisms, imaging biomarkers, and therapeutic opportunities.Frontiers in immunology · 2026Review
- Detection of slowly expanding lesions in people with multiple sclerosis using MRI: A scoping review.Imaging neuroscience (Cambridge, Mass.)Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMultiple sclerosis (MS) slowly expanding lesions (SELs) are defined on magnetic resonance imaging (MRI) as contiguous regions of pre-existing focal non-contrast-enhancing T2 lesions with constant and concentric local expansion on conventional T1-weighted and T2-weighted images. SELs are associated with an increased risk of disability progression.
methodsMyelin-related changes detected using myelin water fraction (MWF) and magnetisation transfer ratio (MTR) in SELs and T2 lesions were measured over 192 weeks in participants with relapsing MS.
resultsIn participants with SELs (SEL+), SELs (MWF: 0.12 ± 0.03, MTR: 33.1 ± 3.6 pu) showed reduced myelin measures at baseline compared to T2 lesions (MWF: 0.13 ± 0.02, MTR: 35.1 ± 2.4 pu). In participants without SELs (SEL-), T2 lesions had higher myelin measures (MWF: 0.15 ± 0.02, MTR: 36.2 ± 2.0 pu) compared to T2 lesions in SEL+. Over 4 years, only SELs showed decreases in MWF (-11.4%). The percentage of abnormal voxels within normal-appearing white matter was higher in SEL+ and increased over time (SEL+ MWF Week 0: 0.56%, Week 192: 0.98%; SEL- MWF Week 0: 0.13%, Week 192: 0.25%).
conclusionOur results indicate progressive focal and global demyelination in SEL+ participants and that the presence of SELs might be a biomarker for participants with ongoing diffuse or smouldering inflammation within the whole brain.
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