{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T22:53:43Z","timestamp":1774565623850,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Paramagnetic rim lesions (PRLs) are emerging MRI biomarkers of smoldering inflammation in multiple sclerosis with prognostic relevance\n                      <jats:sup>1<\/jats:sup>\n                      . However, their prevalence in the early stages of the disease remains underexplored.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This prospective cohort study investigated the prevalence, anatomical distribution, and clinical significance of PRLs in newly diagnosed relapsing MS patients with high disease activity and explored their associations with conventional and non\u2010conventional MRI measures, serum neurofilament light chain (sNfL), and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We enrolled treatment\u2010na\u00efve patients who had received an MS diagnosis in the previous 12\u2009months. Patients underwent 3\u2009T brain and spinal MRI including susceptibility\u2010weighted imaging at baseline, 6, and 12\u2009months, along with neurological and cognitive assessments and sNfL sampling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort consisted of 21 patients, with a mean age of 31 and median disease duration of 9\u2009months (IQR 4\u201317). Median EDSS score was 1.5. All patients presented with spinal cord lesions and 38% showed Gd\u2009+\u2009lesions. PRLs were detected in 76%, with a mean of 4.9 lesions per subject. Higher PRL burden correlated with greater T2 lesion volume and cortical lesion count, higher EDSS, reduced SDMT scores, and elevated baseline sNfL. PRLs remained stable over 12\u2009months despite treatment; two new PRLs emerged at month 12. sNfL levels were higher in patients with \u2265\u20094 PRLs and decreased in all during follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Paramagnetic rim lesions (PRLs) are detectable early in RMS and correlate with a more severe clinical and radiological profile. The combined assessment of PRLs and CLs may improve disease monitoring and guide personalized treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70573","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T13:17:07Z","timestamp":1774012627000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Paramagnetic Rim Lesions in Highly Active Multiple Sclerosis at the Time of Disease Diagnosis: Prevalence Data and Clinical Implications"],"prefix":"10.1111","volume":"33","author":[{"given":"Alessandra","family":"Cicia","sequence":"first","affiliation":[{"name":"Centro di Ricerca Per la Sclerosi Multipla \u201cAnna Paola Batocchi\u201d, Department of Neurosciences Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"},{"name":"Multiple Sclerosis Unit Fondazione Policlinico Universitario A. Gemelli IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Lucchini","sequence":"additional","affiliation":[{"name":"Centro di Ricerca Per la Sclerosi Multipla \u201cAnna Paola Batocchi\u201d, Department of Neurosciences Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"},{"name":"Multiple Sclerosis Unit Fondazione Policlinico Universitario A. Gemelli IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Di Fiore","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Radiation Oncology and Hematology Fondazione Policlinico Universitario \u201cAgostino Gemelli\u201d IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca Ausili","family":"Cefaro","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Radiation Oncology and Hematology Fondazione Policlinico Universitario \u201cAgostino Gemelli\u201d IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Assunta","family":"Bianco","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Unit Fondazione Policlinico Universitario A. Gemelli IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viviana","family":"Nociti","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Unit Fondazione Policlinico Universitario A. Gemelli IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincenzo","family":"Carlomagno","sequence":"additional","affiliation":[{"name":"Centro di Ricerca Per la Sclerosi Multipla \u201cAnna Paola Batocchi\u201d, Department of Neurosciences Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"},{"name":"Multiple Sclerosis Unit Fondazione Policlinico Universitario A. Gemelli IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simona","family":"Gaudino","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Radiation Oncology and Hematology Fondazione Policlinico Universitario \u201cAgostino Gemelli\u201d IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimiliano","family":"Mirabella","sequence":"additional","affiliation":[{"name":"Centro di Ricerca Per la Sclerosi Multipla \u201cAnna Paola Batocchi\u201d, Department of Neurosciences Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"},{"name":"Multiple Sclerosis Unit Fondazione Policlinico Universitario A. Gemelli IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awae013"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra052130"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(17)30470\u20102"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2015.106"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000209444"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/17562864211066751"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.molmed.2024.11.005"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/17562864241306684"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26657"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000001360"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25877"},{"key":"e_1_2_11_13_1","unstructured":"X.Montalban \u201cNew diagnostic criteria oral presentation Presented at ECTRIMS Annual Congress \u201d(2024)."},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.33.11.1444"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458511431076"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.1568"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.20740"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2015.157"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31820a0cc4"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2019.2399"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000200253"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics10110968"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.52256"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A5150"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000207966"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awaa233"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458511406575"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/braincomms\/fcab134"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000012326"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.632749"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00401\u2010016\u20101636\u2010z"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A5660"},{"key":"e_1_2_11_33_1","first-page":"38","article-title":"The Central Vein Sign and Iron Rings: Insights From a Large Cohort of Patients With Multiple Sclerosis and Mimicking Disorders","volume":"25","author":"Clarke M.","year":"2019","journal-title":"Multiple Sclerosis Journal"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.29583"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2023.3997"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458520912379"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458519901272"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000010346"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awab241"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2025.1571605"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458512473190"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.70573","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ene.70573","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.70573","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T22:13:38Z","timestamp":1774563218000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.70573"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":40,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1111\/ene.70573"],"URL":"https:\/\/doi.org\/10.1111\/ene.70573","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"2025-05-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70573"}}