Determinants driving the evolution of new multiple sclerosis lesions into chronic active or remyelinated states
Introduction: Once formed, focal lesions that develop in patients with multiple sclerosis (MS) can follow different trajectories. We aimed at identifying early clinical and MRI features associated with the evolution of new MS lesions into chronic-active versus remyelinated states. Methods: New contr...
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Elsevier
2025-01-01
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| Series: | NeuroImage: Clinical |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213158225000932 |
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| author | G. Boffa C. Razzetta D. Boccia S. Garbarino E. Cipriano A. Uccelli C. Lapucci M. Piana M. Inglese |
| author_facet | G. Boffa C. Razzetta D. Boccia S. Garbarino E. Cipriano A. Uccelli C. Lapucci M. Piana M. Inglese |
| author_sort | G. Boffa |
| collection | DOAJ |
| description | Introduction: Once formed, focal lesions that develop in patients with multiple sclerosis (MS) can follow different trajectories. We aimed at identifying early clinical and MRI features associated with the evolution of new MS lesions into chronic-active versus remyelinated states. Methods: New contrast-enhancing (CE) lesions were classified after a 12-month follow-up with quantitative susceptibility mapping (QSM) into paramagnetic rim lesions (PRLs, representing chronic-active lesions) and isointense QSM lesions (ISO, representing remyelinated lesions). SHapley Additive exPlanations (SHAP) analysis, which highlights the most relevant features contributing to model predictions, was conducted using baseline clinical and MRI characteristics. A risk score was calculated for PRL and ISO classifications using the four most influential features for each task. Results: A total of 111 lesions from 44 MS patients were analyzed. At 12 months, 13 % lesions were classified as PRL and 45 % as ISO. The key predictive features were similar for both classes (lesion volume, patient age and sex) except for the pattern of contrast enhancement (which was selected for PRL classification) and lesion topography (which was selected for ISO classification). Older age (>48 years), male sex, bigger lesion volume (>5 mL) and the presence of a ring pattern of contrast enhancement favored PRLs, while younger age (<36 years), female sex, smaller lesion volume (<0.17 mL) and the juxta-subcortical/deep white matter location favored ISO. Interpretation: The outcome of a new MS lesion can be predicted at lesion onset considering few clinically accessible features. |
| format | Article |
| id | doaj-art-c9abb90a3e2848408d08c341c9e891f2 |
| institution | DOAJ |
| issn | 2213-1582 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | NeuroImage: Clinical |
| spelling | doaj-art-c9abb90a3e2848408d08c341c9e891f22025-08-20T03:21:24ZengElsevierNeuroImage: Clinical2213-15822025-01-014710382310.1016/j.nicl.2025.103823Determinants driving the evolution of new multiple sclerosis lesions into chronic active or remyelinated statesG. Boffa0C. Razzetta1D. Boccia2S. Garbarino3E. Cipriano4A. Uccelli5C. Lapucci6M. Piana7M. Inglese8Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, ItalyDipartimento di Matematica, Università di Genova, Genoa, ItalyDepartment of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, ItalyIRCCS Ospedale Policlinico San Martino, Genoa, Italy; Dipartimento di Matematica, Università di Genova, Genoa, ItalyDepartment of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, ItalyDepartment of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, ItalyIRCCS Ospedale Policlinico San Martino, Genoa, ItalyIRCCS Ospedale Policlinico San Martino, Genoa, Italy; Dipartimento di Matematica, Università di Genova, Genoa, ItalyDepartment of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Corresponding author.Introduction: Once formed, focal lesions that develop in patients with multiple sclerosis (MS) can follow different trajectories. We aimed at identifying early clinical and MRI features associated with the evolution of new MS lesions into chronic-active versus remyelinated states. Methods: New contrast-enhancing (CE) lesions were classified after a 12-month follow-up with quantitative susceptibility mapping (QSM) into paramagnetic rim lesions (PRLs, representing chronic-active lesions) and isointense QSM lesions (ISO, representing remyelinated lesions). SHapley Additive exPlanations (SHAP) analysis, which highlights the most relevant features contributing to model predictions, was conducted using baseline clinical and MRI characteristics. A risk score was calculated for PRL and ISO classifications using the four most influential features for each task. Results: A total of 111 lesions from 44 MS patients were analyzed. At 12 months, 13 % lesions were classified as PRL and 45 % as ISO. The key predictive features were similar for both classes (lesion volume, patient age and sex) except for the pattern of contrast enhancement (which was selected for PRL classification) and lesion topography (which was selected for ISO classification). Older age (>48 years), male sex, bigger lesion volume (>5 mL) and the presence of a ring pattern of contrast enhancement favored PRLs, while younger age (<36 years), female sex, smaller lesion volume (<0.17 mL) and the juxta-subcortical/deep white matter location favored ISO. Interpretation: The outcome of a new MS lesion can be predicted at lesion onset considering few clinically accessible features.http://www.sciencedirect.com/science/article/pii/S2213158225000932Multiple sclerosisParamagnetic rim lesionsChronic active lesionsRemyelinated lesionsQSMIsointense lesions |
| spellingShingle | G. Boffa C. Razzetta D. Boccia S. Garbarino E. Cipriano A. Uccelli C. Lapucci M. Piana M. Inglese Determinants driving the evolution of new multiple sclerosis lesions into chronic active or remyelinated states NeuroImage: Clinical Multiple sclerosis Paramagnetic rim lesions Chronic active lesions Remyelinated lesions QSM Isointense lesions |
| title | Determinants driving the evolution of new multiple sclerosis lesions into chronic active or remyelinated states |
| title_full | Determinants driving the evolution of new multiple sclerosis lesions into chronic active or remyelinated states |
| title_fullStr | Determinants driving the evolution of new multiple sclerosis lesions into chronic active or remyelinated states |
| title_full_unstemmed | Determinants driving the evolution of new multiple sclerosis lesions into chronic active or remyelinated states |
| title_short | Determinants driving the evolution of new multiple sclerosis lesions into chronic active or remyelinated states |
| title_sort | determinants driving the evolution of new multiple sclerosis lesions into chronic active or remyelinated states |
| topic | Multiple sclerosis Paramagnetic rim lesions Chronic active lesions Remyelinated lesions QSM Isointense lesions |
| url | http://www.sciencedirect.com/science/article/pii/S2213158225000932 |
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