{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T07:32:46Z","timestamp":1781249566413,"version":"3.54.1"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000735","name":"University of Cambridge","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000735","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018956","name":"NIHR Cambridge Biomedical Research Centre","doi-asserted-by":"publisher","award":["BRC\u20101215\u201020014"],"award-info":[{"award-number":["BRC\u20101215\u201020014"]}],"id":[{"id":"10.13039\/501100018956","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the pathological mechanisms contributing to white matter (WM) lesion expansion or contraction and remyelination in multiple sclerosis (MS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We assessed 1,613 lesions in 49 people with relapsing\u2013remitting MS in the CCMR\u2010One bexarotene trial (EudraCT 2014\u2010003145\u201099). We measured lesion orientation relative to WM tracts, surface\u2010in gradients and veins. Jacobian deformation was used to assess lesion expansion over 6\u2009months, while magnetization transfer ratio (MTR) imaging was used to assess remyelination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At baseline, 33% of lesions were aligned with veins, 2% along WM tracts, 0% with surface\u2010in gradients, and 4% orthogonal to veins. No significant differences were observed in lesion shape, while lesions aligned with surface\u2010in gradients and with veins had lower volume compared to all remaining orientations. At follow\u2010up, 13% of lesions expanded and 7% contracted. The directions for both expansion and contraction were 18% and 8%, respectively, along WM tracts, 20% and 15% parallel to veins, 22% and 23% orthogonal to veins and 0% and 1% along surface\u2010in gradients. Bexarotene had no effect on lesion expansion or contraction, but MTR significantly increased in lesions aligned with surface\u2010in gradients and veins.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Lesion expansion and shrinkage are affected by venous and WM tract factors, but these do not influence bexarotene's capacity to promote remyelination. This, instead, appears to be affected by surface\u2010in factors. To limit lesion expansion and maximize tissue repair, multiple processes may need to be targeted.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.52308","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T17:13:58Z","timestamp":1737998038000},"page":"686-700","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["An <scp>MRI<\/scp> assessment of mechanisms underlying lesion growth and shrinkage in multiple sclerosis"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5531-1111","authenticated-orcid":false,"given":"Ermelinda","family":"De Meo","sequence":"first","affiliation":[{"name":"NMR Research Unit, Queen Square Multiple Sclerosis Centre, UCL Queen Square Institute of Neurology University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferran","family":"Prados Carrasco","sequence":"additional","affiliation":[{"name":"NMR Research Unit, Queen Square Multiple Sclerosis Centre, UCL Queen Square Institute of Neurology University College London  London UK"},{"name":"Universitat Oberta de Catalunya  Barcelona Spain"},{"name":"Department of Medical Physics and Biomedical Engineering, Centre for Medical Image Computing (CMIC) University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. William L.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4738-0760","authenticated-orcid":false,"given":"Alasdair J.","family":"Coles","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick G.","family":"Cunniffe","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy E.","family":"Jolly","sequence":"additional","affiliation":[{"name":"NMR Research Unit, Queen Square Multiple Sclerosis Centre, UCL Queen Square Institute of Neurology University College London  London 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