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Updated: Dec 27, 2025
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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
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White matter lesion location correlates with disability in relapsing multiple sclerosis
Laura Gaetano1, Baldur Magnusson2, Petya Kindalova3
1Medical Image Analysis Center, Switzerland.
Summary
Sublobar lesions in relapsing-remitting multiple sclerosis significantly correlate with physical disability. Understanding lesion location is key for predicting disease progression and treatment effectiveness.
Area of Science:
- Neuroscience
- Neurology
- Radiology
Background:
- Lesion location is a critical prognostic factor for disease progression and disability accumulation in multiple sclerosis (MS).
- Identifying specific brain regions affected by lesions is crucial for understanding MS pathophysiology.
Purpose of the Study:
- To investigate lesion formation across 11 distinct brain regions in relapsing-remitting multiple sclerosis (RRMS).
- To assess the correlation between lesion location and measures of physical and cognitive disability.
- To evaluate the regional treatment effects of fingolimod compared to placebo.
Main Methods:
- Analysis of T2-weighted lesion number, volume, and density in 11 brain regions from 2355 RRMS patients in the FREEDOMS and FREEDOMS II studies.
- Investigation of lesion formation correlations between brain regions using Spearman correlation.
- Association studies between lesion location and disability (baseline and 2-year change) via linear/logistic regression.
- Assessment of regional fingolimod effects using negative binomial models.
Main Results:
- The majority of lesions at baseline were supratentorial. New and enlarging lesions over 24 months predominantly occurred in frontal and sublobar regions.
- Lesion formation in supratentorial regions showed substantial correlation with pre-existing lesions, while infratentorial correlation was less pronounced.
- High sublobar lesion density was significantly associated with most baseline disability measures and worsening physical disability over 24 months.
- Fingolimod (0.5 mg) demonstrated consistent treatment effects across all investigated brain areas.
Conclusions:
- Sublobar lesions play a significant role in the accrual of disability in RRMS patients.
- These findings emphasize the importance of considering specific lesion locations, particularly sublobar, for predicting MS disability.
- The study supports fingolimod's efficacy across various brain regions in RRMS.
