Lesion location across diagnostic regions in multiple sclerosis

Area of Science:

• Neuroimaging
• Neurology
• Radiology

Background:

• Multiple sclerosis (MS) diagnosis relies on lesions in periventricular, juxtacortical, and infratentorial regions.
• Subcortical lesions are markers of MS disease activity but not diagnostic criteria.
• The spatial distribution patterns of MS lesions remain largely unknown.

Purpose of the Study:

• To characterize the cross-sectional spatial patterns of MS lesions.
• To investigate the spatial association between new and baseline lesions across different brain regions.

Main Methods:

• Analysis of brain MRI scans from 330 early MS patients by experienced neuroradiologists.
• Manual and consensus-based segmentation and classification of baseline and new lesions into periventricular, juxtacortical, infratentorial, and subcortical regions.
• Statistical modeling (zero-inflated Poisson models) to assess associations between new and baseline lesions, considering age and gender.

Main Results:

• Subcortical lesions were most frequent at baseline, while periventricular lesions had the highest volume.
• Subcortical lesions showed lower gadolinium enhancement compared to lesions in diagnostic regions.
• New lesions in periventricular, juxtacortical, and infratentorial regions were associated with baseline lesions in the same regions.
• New subcortical lesions demonstrated a positive association with baseline periventricular lesions and a negative association with baseline infratentorial lesions.

Conclusions:

• MS lesion development is not random; new lesions in diagnostic regions correlate with baseline lesions.
• Subcortical lesions are closely linked to periventricular lesions and contribute significantly to overall lesion burden.
• Subcortical lesions exhibit distinct behavior regarding gadolinium enhancement and spatial associations compared to diagnostic MS lesions.