SynthesisNeuroradiology2025
Characterizing iron rim lesions in multiple sclerosis: a biomarker for disease activity and progression: a systematic review and meta-analysis.
Synthesis in Neuroradiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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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.
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Who cites it
2 citing papers in PubMed.
- Lymphotoxin-dependent elevated meningeal CXCL13:BAFF ratios drive gray matter injury.Nature immunology · 2026Article
- Microstructure-informed deep learning improves thalamic atrophy segmentation and clinical associations in multiple sclerosis and related neuroimmunological diseases.NeuroImage. Clinical · 2026Article
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Authors and funding
14 authors.
Funding
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Abstract
backgroundIron rim lesions (IRLs) have emerged as important biomarkers in multiple sclerosis (MS), indicating chronic active inflammation and neurodegeneration. The purpose of this systematic review and meta-analysis is to assess the prognostic value of IRLs in MS, their impact on clinical outcomes, and their relationship with therapeutic responses.
methodsA thorough search was conducted across PubMed, Scopus, Web of Science, and Google Scholar, covering studies published until June 10, 2024. The inclusion criteria included studies on MS patients who had IRLs detected using advanced MRI techniques, particularly susceptibility-weighted imaging (SWI). The meta-analysis included 13 studies and a total of 924 MS patients. The data on clinical outcomes (EDSS scores, relapse rates), brain volume, and white matter lesion (WML) burden were combined. For continuous variables, effect sizes were calculated using standardized mean differences (SMDs), and for binary outcomes, relative risks (RRs).
resultsThis meta-analysis indicated significant correlations between IRLs and poorer clinical outcomes. IRL-positive individuals had higher EDSS scores (SMD 0.77, 95% CI: 0.34-1.21, p = 0.000), indicating a more severe impairment. They also had a larger WML load (SMD 0.52, 95% CI: 0.01-1.03, p = 0.000) and a smaller brain volume (SMD -0.50, 95% CI -0.82 to -0.19, p = 0.015). The relapse rate ratio was 1.10 (95% CI 0.73-1.65, p = 0.499), indicating a trend toward more frequent relapses in IRL-positive patients, though not statistically significant. Treatment response to disease-modifying treatments (DMTs) was similar in IRL-positive and negative individuals (RR 0.97, 95% CI: 0.89-1.06, p = 0.424). However, IRL-positive patients who received high-dose DMTs (HDMT) had a trend toward better outcomes (RR 1.2, 95% CI 0.94-1.52, p = 0.424).
conclusionsIRLs are strongly linked to higher disease severity, lesion burden, and neurodegeneration in MS patients. These lesions should be considered in routine medical evaluations since they are reliable prognostic indicators. Early intervention with high-dose treatment might offer potential benefits for IRL-positive patients, but further research is needed to determine the long-term clinical implications.
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