Evidence map›Paper›PMID 41940957›Full record

ArticleJournal of neurology2026

Dura mater enhancement on 3T MRI is associated with cortical lesion burden in multiple sclerosis.

Robert Zivadinov, Mehak Semy, Alexander Bartnik, Franziska E Hildesheim, Ashley Tranquille, Dejan Jakimovski, David Hojnacki, Svetlana Eckert, Bianca Weinstock-Guttman, Michael G Dwyer and 1 more

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Article in Journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

11 authors.

Robert ZivadinovBuffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 77 Goodell Street, Suite 450, Buffalo, NY, 14203, USA. rz4@buffalo.edu.ORCID http://orcid.org/0000-0002-7799-1485
Mehak SemyBuffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 77 Goodell Street, Suite 450, Buffalo, NY, 14203, USA.
Alexander BartnikBuffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 77 Goodell Street, Suite 450, Buffalo, NY, 14203, USA.
Franziska E HildesheimBuffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 77 Goodell Street, Suite 450, Buffalo, NY, 14203, USA.
Ashley TranquilleBuffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 77 Goodell Street, Suite 450, Buffalo, NY, 14203, USA.
Dejan JakimovskiBuffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 77 Goodell Street, Suite 450, Buffalo, NY, 14203, USA.
David HojnackiDepartment of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
Svetlana EckertDepartment of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
Bianca Weinstock-GuttmanDepartment of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
Michael G DwyerBuffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 77 Goodell Street, Suite 450, Buffalo, NY, 14203, USA.
Niels BergslandBuffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 77 Goodell Street, Suite 450, Buffalo, NY, 14203, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPost-contrast FLAIR MRI can demonstrate meningeal signal enhancement in people with multiple sclerosis (pwMS), including enhancement along the leptomeninges and dura mater. Although these enhancement patterns have been variably interpreted as reflecting inflammatory processes, their biological specificity and relationship to cortical lesion pathology remain uncertain.

objectiveTo evaluate the association between cortical lesion burden and distinct patterns of meningeal enhancement (ME), including dura mater enhancement (DME), leptomeningeal enhancement (LME), and meningeal perivascular enhancement (MPVE) on MRI in pwMS.

methods214 pwMS (173 relapsing-remitting, 41 progressive) underwent 3T MRI including 3D FLAIR pre- and post-contrast, and subtraction imaging. ME (LME + DME) and MPVE were visually classified. Cortical lesions were quantified using a validated multi-modal approach incorporating MMCLE, FLAIR-squared, AI-DIR, and T1/T2 ratio maps, with expert verification. Analyses were adjusted for age, sex, disease duration, disease subtype, and disease-modifying treatment, and corrected for multiple comparisons.

results142 (66.4%) pwMS showed combined ME/MPVE, 121 (56.5%) ME, including 97 (45.3%) with DME and 48 (22.4%) with LME. Additionally, 46 (21.5%) exhibited MPVE. A higher prevalence and frequency of LME + pwMS were observed in older age groups (p = 0.002), whereas no such age-related pattern was found for DME + or MPVE + pwMS. DME + pwMS showed greater cortical lesion number (9.6 vs. 4.9, p = 0.003) and volume (374.1 mm

conclusionsDME on 3T MRI is associated with increased cortical lesion burden in pwMS.

Indexed as

Cerebral CortexDura MaterMagnetic Resonance ImagingMultiple SclerosisMultiple Sclerosis, Chronic ProgressiveMultiple Sclerosis, Relapsing-RemittingAdultFemaleHumansMaleMeningesMiddle AgedCortical lesionsDura mater enhancementLeptomeningeal enhancementMeningeal perivascular enhancementMultiple sclerosis

Identifiers

PMID41940957
PMCPMC13053467

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Registered trials

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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.