Evidence map›Paper›PMID 40020214›Full record

ArticleNeurology(R) neuroimmunology & neuroinflammation2025

Evolution of Chronic Lesion Tissue in Relapsing-Remitting Patients With Multiple Sclerosis: An Association With Disease Progression.

Samuel Klistorner, Michael Barnett, John D E Parratt, Con Yiannikas, Chenyu Wang, Dongang Wang, Andy Shieh, Alexander Klistorner

Registry-linked trialAbstract read
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In one paragraph

Article in Neurology(R) neuroimmunology & neuroinflammation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07500727 (Skeletal Muscle Aging and Responsiveness in Aged People With MS), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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.

NCT07500727 narecruitingnot on this mapstarted 2026, after this paper: background citation

Skeletal Muscle Aging and Responsiveness in Aged People With MS

TypeinterventionalSponsorOklahoma Medical Research FoundationRan2026 to 2026Enrolled10ConditionsMultiple Sclerosis, AgingArmsExercise trial consisting of both cardiovascular and strength training
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
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

8 authors.

Samuel KlistornerSave Sight Institute, Sydney Medical School, University of Sydney, Australia.ORCID 0000-0001-5761-5178
Michael BarnettBrain and Mind Centre, University of Sydney, Australia.ORCID 0000-0002-2156-8864
John D E ParrattRoyal North Shore Hospital, Sydney, Australia.
Con YiannikasRoyal North Shore Hospital, Sydney, Australia.
Chenyu WangBrain and Mind Centre, University of Sydney, Australia.
Dongang WangBrain and Mind Centre, University of Sydney, Australia.
Andy ShiehSydney Neuroimaging Analysis Centre, Camperdown, Australia.
Alexander KlistornerSave Sight Institute, Sydney Medical School, University of Sydney, Australia.ORCID 0000-0003-0361-6399

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesIn this study, we examine the long-term changes in chronic lesion tissue (CLT) among patients with relapsing-remitting MS (RRMS), focusing on its impact on clinical and radiologic disease progression indicators.

methodsThe study involved 72 patients with multiple sclerosis with at least a 5-year follow-up. Annual assessments used 3D fluid-attenuated inversion recovery (FLAIR), precontrast and postcontrast 3D T1, and diffusion-weighted MRI. Lesion segmentation was conducted using iQ-MS software, while brain structures were segmented using AssemblyNet. Volumetric changes in CLT were tracked using a novel custom-designed pipeline that estimates longitudinal volumetric changes in CLT using serial MRI data.

resultsThroughout the follow-up period, the volume of CLT in the entire cohort increased continuously and steadily, averaging 7.75% ± 8.2% or 315 ± 465 mm³ per year. Patients with expanding CLT experienced significantly faster brain atrophy, affecting both white and gray matter, particularly in the brain's central area. Expanded CLT was also associated with higher and worsening Expanded Disability Status Scale (EDSS) scores, in contrast to the stable CLT group, where EDSS remained unchanged. Sample size calculation for a clinical trial investigating the effect of treatment on slow expansion of chronic lesions demonstrated that a relatively small cohort of patients with RRMS, ranging from 24 to 69 patients per arm, would be required. DISCUSSION: This study demonstrates that, over a period of up to 5 years, patient-specific enlargement of CLT, when present, progresses at a constant rate and significantly influences brain atrophy and disease progression. In addition, the study underscores CLT as a promising biomarker for RRMS progression and suggests the feasibility of smaller, targeted clinical trials to evaluate treatments aimed at reducing chronic lesion expansion.

Indexed as

BrainDisease ProgressionGray MatterMultiple Sclerosis, Relapsing-RemittingWhite MatterAdultAtrophyFemaleFollow-Up StudiesHumansLongitudinal StudiesMagnetic Resonance ImagingMaleMiddle AgedYoung Adult

Identifiers

PMID40020214
PMCPMC11908449

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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.