• Hiroaki Yokote, Yusei Miyazaki, Juichi Fujimori, Yoichiro Nishida, Shuta Toru, Masaaki Niino, Ichiro Nakashima, Yoshiharu Miura, and Takanori Yokota.
• Department of Neurology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan.
• J Neuroimaging. 2024 Nov 1; 34 (6): 758765758-765.

Background And PurposeSlowly expanding lesions (SELs) have been proposed as novel MRI markers of chronic active lesions in multiple sclerosis (MS). However, the mechanism through which SELs affect brain volume loss in patients with MS remains unknown. Additionally, the prevalence and significance of SELs in Asian patients with MS remain unclear. This study aimed to investigate the association between SELs and no evidence of disease activity (NEDA)-3 status as well as brain volume loss in Japanese patients.MethodsA total of 99 patients with relapse-onset MS were retrospectively evaluated. SELs were identified on brain MRI based on local deformation when consecutive scans were registered longitudinally. We developed a logistic regression model and generalized linear mixed models (GLMMs) to evaluate the association between the number of SELs and disease activity and changes in brain volume.ResultsDuring the observation period (2.0 ± 0.22 years), 35 patients developed at least one SEL. Multivariable logistic regression analysis showed that ≥2 SELs were associated with 0.2 times the risk of achieving a NEDA-3 status. GLMMs revealed that the number of SELs was negatively associated with volume changes in the cortex (p = .00169) and subcortical gray matter (p = .00964) after correction for multiple comparisons.ConclusionSELs were identified in Japanese patients with MS during the 2-year observation period. The number of SELs is associated with disease activity and brain volume loss, suggesting that the number of SELs could be a biomarker of disease activity in MS.© 2024 American Society of Neuroimaging.

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