{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T03:42:17Z","timestamp":1788838937059,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004755","name":"EMD Serono","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004755","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuroimaging"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Purpose<\/jats:title><jats:p>Cladribine, an FDA\u2010approved disease\u2010modifying immunotherapy for multiple sclerosis (MS), penetrates the CSF and mitigates T cells and B cells, and thus may impact the development of cortical gray matter lesions (CLs) and leptomeningeal enhancement (LME). 7T MRI is a highly sensitive tool for monitoring these outcomes in relapsing\u2010remitting (RR) MS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>MS subjects (<jats:italic>n<\/jats:italic>\u00a0=\u00a019, age [mean\u00a0\u00b1\u00a0standard deviation]: 48.8\u00a0\u00b1\u00a010.0\u00a0years, 63.1% RRMS, 36.9% secondary progressive MS, Expanded Disability Status Scale [EDSS] score 4.1\u00a0\u00b1\u00a02.0) underwent 7T MRI with 0.7\u2010mm<jats:sup>3<\/jats:sup> voxels within a mean 1.9\u00a0months of oral cladribine initiation and \u223c1\u00a0year later in this real\u2010world study. CLs and LME were quantified by an expert. Wilcoxon signed rank tests and paired <jats:italic>t<\/jats:italic>\u2010tests compared baseline to follow\u2010up data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 88.2% of subjects had CLs at baseline (mean 14.1\u00a0CLs\/patient, range 1\u201377). No subjects accrued new CLs, and CL volume remained stable (0.33\u00a0\u00b1\u00a00.48\u00a0mL baseline vs. 0.31\u00a0\u00b1\u00a00.46\u00a0mL follow\u2010up, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.22). LME was found in 88.9% of subjects at baseline. LME foci number was stable in seven (41.2%), increased in five (29.4%), and decreased in five (29.4%) subjects at follow\u2010up, but overall LME burden was stable (3.1\u00a0\u00b1\u00a01.8\u00a0vs. 3.2\u00a0\u00b1\u00a01.6 foci per subject, <jats:italic>p<\/jats:italic>\u00a0=\u00a01.0). No EDSS or timed 25\u2010foot walk change was noted (both <jats:italic>p<\/jats:italic>\u00a0&gt;\u00a00.35). No subjects had clinical relapses or new T2 or gadolinium\u2010enhancing white matter lesions during the study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These observational data suggest that cladribine therapy stabilizes cortical demyelination in MS over the first year of treatment. Overall, LME burden remained stable over 1\u00a0year; however, within\u2010subject resolution and accrual were noted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jon.70032","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T05:34:12Z","timestamp":1742362452000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Cladribine Is Associated With Stable Cortical Gray Matter Lesion Burden in Multiple Sclerosis: A 7T MRI Study"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2896-8369","authenticated-orcid":false,"given":"Jonathan","family":"Zurawski","sequence":"first","affiliation":[{"name":"Departments of Neurology Brigham &amp; Women's Hospital Multiple Sclerosis Center, Ann Romney Center for Neurological Diseases, Laboratory for Neuroimaging Research, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahamat","family":"Tauhid","sequence":"additional","affiliation":[{"name":"Departments of Neurology Brigham &amp; Women's Hospital Multiple Sclerosis Center, Ann Romney Center for Neurological Diseases, Laboratory for Neuroimaging Research, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian C.","family":"Healy","sequence":"additional","affiliation":[{"name":"Departments of Neurology Brigham &amp; Women's Hospital Multiple Sclerosis Center, Ann Romney Center for Neurological Diseases, Laboratory for Neuroimaging Research, Harvard Medical School  Boston Massachusetts USA"},{"name":"Departments of Biostatistics Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renxin","family":"Chu","sequence":"additional","affiliation":[{"name":"Departments of Neurology Brigham &amp; Women's Hospital Multiple Sclerosis Center, Ann Romney Center for Neurological Diseases, Laboratory for Neuroimaging Research, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria K.","family":"Houtchens","sequence":"additional","affiliation":[{"name":"Departments of Neurology Brigham &amp; Women's Hospital Multiple Sclerosis Center, Ann Romney Center for Neurological Diseases, Laboratory for Neuroimaging Research, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youmna","family":"Jalkh","sequence":"additional","affiliation":[{"name":"Departments of Neurology Brigham &amp; Women's Hospital Multiple Sclerosis Center, Ann Romney Center for Neurological Diseases, Laboratory for Neuroimaging Research, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samar","family":"Khalil","sequence":"additional","affiliation":[{"name":"Departments of Neurology Brigham &amp; Women's Hospital Multiple Sclerosis Center, Ann Romney Center for Neurological Diseases, Laboratory for Neuroimaging Research, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"Quattrucci","sequence":"additional","affiliation":[{"name":"Departments of Neurology Brigham &amp; Women's Hospital Multiple Sclerosis Center, Ann Romney Center for Neurological Diseases, Laboratory for Neuroimaging Research, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farrah J.","family":"Mateen","sequence":"additional","affiliation":[{"name":"Departments of Neurology Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Napoli","sequence":"additional","affiliation":[{"name":"Neurology Center of New England  Foxborough Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed","family":"Rizvi","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Center of Rhode Island Brown University Medical School  Providence Rhode Island US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarun","family":"Singhal","sequence":"additional","affiliation":[{"name":"Departments of Neurology Brigham &amp; Women's Hospital Multiple Sclerosis Center, Ann Romney Center for Neurological Diseases, Laboratory for Neuroimaging Research, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8601-5534","authenticated-orcid":false,"given":"Rohit","family":"Bakshi","sequence":"additional","affiliation":[{"name":"Departments of Neurology Brigham &amp; Women's Hospital Multiple Sclerosis Center, Ann Romney Center for Neurological Diseases, Laboratory for Neuroimaging Research, Harvard Medical School  Boston Massachusetts USA"},{"name":"Departments of Radiology Brigham &amp; Women's Hospital Multiple Sclerosis Center, Ann Romney Center for Neurological Diseases, Laboratory for Neuroimaging Research, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0902533"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.54.5.1145"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/WNF.0b013e318204cd90"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)92826-2"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.2004.00259.x"},{"key":"e_1_2_7_7_1","first-page":"93","article-title":"Effect of Immunosuppressive Cladribine Treatment on Serum Leucocytes System in Two\u2010Year Clinical Trial in Patients With Chronic Progressive Multiple Sclerosis","volume":"7","author":"Janiec K.","year":"2001","journal-title":"Medical Science Monitor"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2008.02433.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11206006"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1343892"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26684"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458517727603"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/13524585231161494"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40120-022-00339-7"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458517690269"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001587"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458516678083"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/jon.12444"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458519885106"},{"issue":"3","key":"e_1_2_7_20_1","first-page":"1","article-title":"7T MRI Cerebral Leptomeningeal Enhancement Predicts Gray and White Matter Lesion Accumulation One Year Later in Relapsing\u2010Remitting Multiple Sclerosis","volume":"26","author":"Zurawski J.","year":"2020","journal-title":"Multiple Sclerosis"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2011.11.032"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-024-12656-y"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2019181719"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh641"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1100648"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25365"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awr182"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582\u2010023\u201000838\u20107"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awab045"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2022.104094"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/13524585221122210"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2023.105344"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1373385"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/jon.12774"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.26816"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458510394702"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181f5d4da"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.64.10.1416"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/braincomms\/fcae359"}],"container-title":["Journal of Neuroimaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jon.70032","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T10:42:11Z","timestamp":1745836931000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jon.70032"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":38,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1111\/jon.70032"],"URL":"https:\/\/doi.org\/10.1111\/jon.70032","archive":["Portico"],"relation":{},"ISSN":["1051-2284","1552-6569"],"issn-type":[{"value":"1051-2284","type":"print"},{"value":"1552-6569","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3]]},"assertion":[{"value":"2024-11-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70032"}}