TY - JOUR
T1 - Prognostic significance of paramagnetic rim lesions in multiple sclerosis
T2 - A systematic review
AU - Toru Asahina, Adon
AU - Lu, Joe
AU - Chugh, Pooja
AU - Sharma, Srishti
AU - Sharma, Prakriti
AU - Tan, Sheryn
AU - Kovoor, Joshua
AU - Stretton, Brandon
AU - Gupta, Aashray
AU - Sorby-Adams, Annabel
AU - Goh, Rudy
AU - Harroud, Adil
AU - Clarke, Margareta A
AU - Evangelou, Nikos
AU - Patel, Sandy
AU - Dwyer, Andrew
AU - Agzarian, Marc
AU - Bacchi, Stephen
AU - Slee, Mark
PY - 2024/11
Y1 - 2024/11
N2 - The diagnostic potential of paramagnetic rim lesions (PRLs) has been previously established; however, the prognostic significance of these lesions has not previously been consistently described. This study aimed to establish the prognostic role of PRLs in MS with respect to the Expanded Disability Status Scale (EDSS) and rates of disability progression. Databases of PubMed, EMBASE, Scopus and reference lists of selected articles were searched up to 29/04/2023. The review was conducted in accordance with PRISMA guidelines and was registered prospectively on PROSPERO (CRD42023422052). 7 studies were included in the final review. All of the eligible studies found that patients with PRLs tend to have higher baseline EDSS scores. Longitudinal assessments revealed greater EDSS progression in patients with PRLs over time in most studies. However, the effect of location of PRLs within the central nervous system were not assessed across the studies. Only one study investigated progression independent of relapse activity (PIRA) and showed that this clinical entity occurred in a greater proportion in patients with PRLs. This review supports PRLs as a predictor of EDSS progression. This measure has widespread applicability, however further multicentre studies are needed. Future research should explore the impact of PRLs on silent disability, PIRA, take into account different MS phenotypes and the topography of PRLs in prognosis.
AB - The diagnostic potential of paramagnetic rim lesions (PRLs) has been previously established; however, the prognostic significance of these lesions has not previously been consistently described. This study aimed to establish the prognostic role of PRLs in MS with respect to the Expanded Disability Status Scale (EDSS) and rates of disability progression. Databases of PubMed, EMBASE, Scopus and reference lists of selected articles were searched up to 29/04/2023. The review was conducted in accordance with PRISMA guidelines and was registered prospectively on PROSPERO (CRD42023422052). 7 studies were included in the final review. All of the eligible studies found that patients with PRLs tend to have higher baseline EDSS scores. Longitudinal assessments revealed greater EDSS progression in patients with PRLs over time in most studies. However, the effect of location of PRLs within the central nervous system were not assessed across the studies. Only one study investigated progression independent of relapse activity (PIRA) and showed that this clinical entity occurred in a greater proportion in patients with PRLs. This review supports PRLs as a predictor of EDSS progression. This measure has widespread applicability, however further multicentre studies are needed. Future research should explore the impact of PRLs on silent disability, PIRA, take into account different MS phenotypes and the topography of PRLs in prognosis.
KW - Prognostication
KW - Progression independent of relapse activity
KW - Radiology
KW - Susceptibility-weighted imaging
UR - http://www.scopus.com/inward/record.url?scp=85202830096&partnerID=8YFLogxK
U2 - 10.1016/j.jocn.2024.110810
DO - 10.1016/j.jocn.2024.110810
M3 - Review article
C2 - 39232367
AN - SCOPUS:85202830096
SN - 0967-5868
VL - 129
JO - Journal of Clinical Neuroscience
JF - Journal of Clinical Neuroscience
M1 - 110810
ER -
