Dark Rimmed Brain Lesions May Be Signal of Aggressive Disease, NIH Study Says

Brain lesions appearing as dark rimmed, “smoldering” spots on imaging scans, representing active inflammation, may be a hallmark of more aggressive and disabling forms of multiple sclerosis (MS), researchers at the National Institutes of Health(NIH) report.

Using a powerful MRI brain scanner and a 3D printer, the team visualized brain images from nearly 200 MS patients and found that these spots — identified as chronic active lesions — may be used to signal people at a higher risk of more aggressive and progressing forms of the disease.

“We found that it is possible to use brain scans to detect which patients are highly susceptible to the more aggressive forms of multiple sclerosis. The more chronic active lesions a patient has, the greater the chances they will experience this type of MS,” Daniel S. Reich, MD, PhD, the study’s senior author and a senior investigator at the NIH, said a news release.

“We hope these results will help test the effectiveness of new therapies for this form of MS, and reduce the suffering patients experience,” Reich added.

Previously, chronic active lesions could only be detected through an autopsy. But Reich and his team in earlier work showed that examining a living person’s brain using a highly powerful 7-tesla MRI scanner could accurately capture these lesions by their darkened, outer rims.

“Figuring out how to spot chronic active lesions was a big step, and we could not have done it without the high-powered MRI scanner provided by the NIH. It allowed us to then explore how MS lesions evolved and whether they played a role in progressive MS,” said Martina Absinta, MD, PhD, the study’s leader and a post-doctoral fellow in Reich’s lab.