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TSPO-Detectable Chronic Active Lesions Predict Disease Progression in Multiple Sclerosis

BACKGROUND AND OBJECTIVES: In the multiple sclerosis (MS) brain, chronic active lesions can be detected using MRI- and PET-based methods. In this study, we investigated whether the frequency of TSPO-PET–detectable chronic active lesions associates with disease progression measured using the Expanded...

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Detalles Bibliográficos
Autores principales: Polvinen, Eero, Matilainen, Markus, Nylund, Marjo, Sucksdorff, Marcus, Airas, Laura M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10291892/
https://www.ncbi.nlm.nih.gov/pubmed/37349108
http://dx.doi.org/10.1212/NXI.0000000000200133
Descripción
Sumario:BACKGROUND AND OBJECTIVES: In the multiple sclerosis (MS) brain, chronic active lesions can be detected using MRI- and PET-based methods. In this study, we investigated whether the frequency of TSPO-PET–detectable chronic active lesions associates with disease progression measured using the Expanded Disability Status Scale (EDSS) at 5-year follow-up. METHODS: Chronic lesion–associated innate immune cell activation was evaluated using TSPO-PET in 82 patients with MS. Chronic lesions were categorized into rim-active, inactive, and overall active lesion subtypes based on innate immune cell activation patterns in the lesion core and at the 2-mm perilesional rim. Logistic regression was used to identify best predictors of progression. RESULTS: Twenty-one patients experienced disability progression during the follow-up. These patients had a significantly higher proportion of rim-active lesions (p < 0.001) and a significantly lower proportion of inactive lesions (p = 0.001) compared with nonprogressed patients. The results were similar in the patient group having no relapses during the follow-up (60 patients, 14 experienced progression). In logistic regression modeling, the categorized variable “patients with >10% rim-active lesions and ≤50% inactive lesions of all chronic lesions” predicted disease progression in the entire cohort (OR = 26.8, p < 0.001) and in the group free of relapses (OR = 34.8, p = 0.002). DISCUSSION: The results show that single TSPO-PET–based in vivo lesion phenotyping of chronic MS lesions provides a strong predictor for MS disease progression. This emphasizes the significance of chronic active lesions in disability accumulation in MS.