Chronic, Active Lesions Tied to More Aggressive MS

Stuart SchlossmanMS Research Study and Reports

— Smoldering inflammation seen even in patients treated with effective disease-modifying therapies

by Senior Staff Writer, MedPage Today 
Dark rimmed spots, representing ongoing inflammation, maybe a sign of more disabling forms of MS. Credit: Reich lab, /NINDS
Chronic active lesions — dark-rimmed spots indicating ongoing, smoldering inflammation on 3T or 7T MRI susceptibility sequences — were common in multiple sclerosis (MS) and tied to disability accumulation, a prospective study showed.
Chronic lesions with a paramagnetic rim were associated with more aggressive disease and ongoing tissue damage and occurred even in MS patients treated with effective disease-modifying therapies, reported Daniel Reich, MD, PhD, of the NIH National Institute of Neurological Disorders and Stroke (NINDS) in Bethesda, Maryland, and colleagues.
Until recently, these lesions could be detected only at autopsy, they stated in JAMA Neurology.
“In MS, the standard of care is to follow patients with MRI scans and to treat active inflammation,” Reich said. “In this new work, we show that MRI can also detect and evaluate chronic smoldering inflammation which involves microglial cells — the so-called ‘police force’ of the brain.”
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