{"doi":"10.1002/ana.26441","title":"A New Advanced<scp>MRI</scp>Biomarker for Remyelinated Lesions in Multiple Sclerosis","abstract":"OBJECTIVES: Neuropathological studies have shown that multiple sclerosis (MS) lesions are heterogeneous in terms of myelin/axon damage and repair as well as iron content. However, it remains a challenge to identify specific chronic lesion types, especially remyelinated lesions, in vivo in patients with MS. METHODS: We performed 3 studies: (1) a cross-sectional study in a prospective cohort of 115 patients with MS and 76 healthy controls, who underwent 3 T magnetic resonance imaging (MRI) for quantitative susceptibility mapping (QSM), myelin water fraction (MWF), and neurite density index (NDI) maps. White matter (WM) lesions in QSM were classified into 5 QSM lesion types (iso-intense, hypo-intense, hyperintense, lesions with hypo-intense rims, and lesions with paramagnetic rim legions [PRLs]); (2) a longitudinal study of 40 patients with MS to study the evolution of lesions over 2 years; (3) a postmortem histopathology-QSM validation study in 3 brains of patients with MS to assess the accuracy of QSM classification to identify neuropathological lesion types in 63 WM lesions. RESULTS: At baseline, hypo- and isointense lesions showed higher mean MWF and NDI values compared to other QSM lesion types (p < 0.0001). Further, at 2-year follow-up, hypo-/iso-intense lesions showed an increase in MWF. Postmortem analyses revealed that QSM highly accurately identifies (1) fully remyelinated areas as hypo-/iso-intense (sensitivity = 88.89% and specificity = 100%), (2) chronic inactive lesions as hyperintense (sensitivity = 71.43% and specificity = 92.00%), and (3) chronic active/smoldering lesions as PRLs (sensitivity = 92.86% and specificity = 86.36%). INTERPRETATION: These results provide the first evidence that it is possible to distinguish chronic MS lesions in a clinical setting, hereby supporting with new biomarkers to develop and assess remyelinating treatments. ANN NEUROL 2022;92:486-502.","journal":"Annals of Neurology","year":2022,"id":235178,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":84,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8359,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":635207,"name":"Riccardo Galbusera","orcid":"0000-0002-3092-8737","position":1,"is_corresponding":false},{"id":320262,"name":"Po‐Jui Lu","orcid":"0000-0001-6031-6865","position":2,"is_corresponding":false},{"id":852779,"name":"Erik Bahn","orcid":"0009-0002-9747-0211","position":3,"is_corresponding":false},{"id":320264,"name":"Matthias Weigel","orcid":"0000-0002-4910-1414","position":4,"is_corresponding":false},{"id":467184,"name":"Muhamed Baraković","orcid":"0000-0001-8557-9223","position":5,"is_corresponding":false},{"id":852780,"name":"Jonas Franz","orcid":"0000-0001-7523-6622","position":6,"is_corresponding":false},{"id":314691,"name":"Thanh D. Nguyen","orcid":"0000-0002-1411-7694","position":7,"is_corresponding":false},{"id":314690,"name":"Pascal Spincemaille","orcid":"0000-0002-8821-1341","position":8,"is_corresponding":false},{"id":553909,"name":"Simona Schiavi","orcid":"0000-0003-1641-186X","position":9,"is_corresponding":false},{"id":467188,"name":"Alessandro Daducci","orcid":"0000-0002-4677-6678","position":10,"is_corresponding":false},{"id":308518,"name":"Francesco La Rosa","orcid":"0000-0002-9224-4664","position":11,"is_corresponding":false},{"id":247676,"name":"Martina Absinta","orcid":"0000-0003-0276-383X","position":12,"is_corresponding":false},{"id":247663,"name":"Pascal Sati","orcid":"0000-0002-6763-0125","position":13,"is_corresponding":false},{"id":308520,"name":"Meritxell Bach Cuadra","orcid":"0000-0003-2730-4285","position":14,"is_corresponding":false},{"id":853773,"name":"Ernst‐Wilhelm Radue","orcid":null,"position":15,"is_corresponding":false},{"id":635209,"name":"David Leppert","orcid":"0000-0001-6172-801X","position":16,"is_corresponding":false},{"id":320893,"name":"Jens Kühle","orcid":"0000-0002-6963-8892","position":17,"is_corresponding":false},{"id":27468,"name":"Ludwig Kappos","orcid":"0000-0003-4175-5509","position":18,"is_corresponding":false},{"id":387819,"name":"Wolfgang Brück","orcid":"0000-0002-6881-4479","position":19,"is_corresponding":false},{"id":230800,"name":"Daniel S. Reich","orcid":"0000-0002-2628-4334","position":20,"is_corresponding":false},{"id":635210,"name":"Christine Stadelmann","orcid":"0000-0003-1766-5458","position":21,"is_corresponding":false},{"id":394821,"name":"Yi Wang","orcid":"0000-0001-6880-5831","position":22,"is_corresponding":false},{"id":308521,"name":"Cristina Granziera","orcid":"0000-0002-4917-8761","position":23,"is_corresponding":false},{"id":320263,"name":"Reza Rahmanzadeh","orcid":"0000-0002-5091-0585","position":0,"is_corresponding":true}],"reference_count":75,"raw_metadata":null,"created_at":"2026-07-19T00:21:48.116752Z","pmid":"35713309","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}