{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T02:16:41Z","timestamp":1789265801878,"version":"build-2803163510"},"reference-count":33,"publisher":"SAGE Publications","issue":"14","license":[{"start":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T00:00:00Z","timestamp":1616371200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["1K23NS109328"],"award-info":[{"award-number":["1K23NS109328"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["R35 NS097303"],"award-info":[{"award-number":["R35 NS097303"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013995","name":"sanofi genzyme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013995","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Describe magnetic resonance imaging (MRI) susceptibility changes in progressive multifocal leukoencephalopathy (PML) and identify neuropathological correlates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>PML cases and matched controls with primary central nervous system lymphoma (PCNSL) were retrospectively identified. MRI brain at 3 T and 7 T were reviewed. MRI-pathology correlations in fixed brain autopsy tissue were conducted in three subjects with confirmed PML.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>With PML ( n = 26 total, n = 5 multiple sclerosis natalizumab-associated), juxtacortical changes on susceptibility-weighted imaging (SWI) or gradient echo (GRE) sequences were noted in 3\/3 cases on 7 T MRI and 14\/22 cases (63.6%) on 1.5 T or 8\/22 (36.4%) 3 T MRI. Similar findings were only noted in 3\/25 (12.0%) of PCNSL patients (odds ratio (OR) 12.83, 95% confidence interval (CI), 2.9\u201356.7, p &lt; 0.001) on 1.5 or 3 T MRI. On susceptibility sequences available prior to diagnosis of PML, 7 (87.5%) had changes present on average 2.7 \u00b1 1.8\u2009months (mean \u00b1 SD) prior to diagnosis. Postmortem 7 T MRI showed SWI changes corresponded to areas of increased iron density along the gray\u2013white matter (GM-WM) junction predominantly in macrophages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Susceptibility changes in PML along the GM-WM junction can precede noticeable fluid-attenuated inversion recovery (FLAIR) changes and correlates with iron accumulation in macrophages.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1352458521999651","type":"journal-article","created":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T06:52:51Z","timestamp":1616395971000},"page":"2159-2169","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Juxtacortical susceptibility changes in progressive multifocal leukoencephalopathy at the gray\u2013white matter junction correlates with iron-enriched macrophages"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0339-9876","authenticated-orcid":false,"given":"Kedar R","family":"Mahajan","sequence":"first","affiliation":[{"name":"Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA\/Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9587-0644","authenticated-orcid":false,"given":"Moein","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Poturalski","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Herman","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Androjna","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Howell","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4263-3717","authenticated-orcid":false,"given":"Robert J","family":"Fox","sequence":"additional","affiliation":[{"name":"Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce D","family":"Trapp","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen E","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7833-8138","authenticated-orcid":false,"given":"Kunio","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2838-9148","authenticated-orcid":false,"given":"Daniel","family":"Ontaneda","sequence":"additional","affiliation":[{"name":"Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,3,22]]},"reference":[{"key":"bibr1-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1007\/s13365-016-0482-z"},{"key":"bibr2-1352458521999651","volume":"1","author":"MacDonald JK","year":"2007","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr3-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2019.2670"},{"key":"bibr4-1352458521999651","volume-title":"ECTRIMS","author":"Giovannoni G"},{"key":"bibr5-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2017.01.006"},{"key":"bibr6-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1007\/s13365-015-0316-4"},{"key":"bibr7-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1177\/1756285615602832"},{"key":"bibr8-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2017008201"},{"key":"bibr9-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0168376"},{"key":"bibr10-1352458521999651","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2013.00011"},{"key":"bibr11-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1007\/s13365-013-0173-y"},{"key":"bibr12-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70028-4"},{"key":"bibr13-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31821a446b"},{"key":"bibr14-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31828c2fa1"},{"key":"bibr15-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1177\/1352458513510224"},{"key":"bibr16-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-019-1407-2"},{"key":"bibr17-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2014.06.018"},{"key":"bibr18-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurad.2015.08.001"},{"key":"bibr19-1352458521999651","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4436"},{"key":"bibr20-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1007\/s13365-020-00845-0"},{"key":"bibr21-1352458521999651","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2017.00294"},{"key":"bibr22-1352458521999651","doi-asserted-by":"publisher","DOI":"10.3988\/jcn.2017.13.2.201"},{"key":"bibr23-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2016.01.036"},{"key":"bibr24-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001455"},{"key":"bibr25-1352458521999651","doi-asserted-by":"publisher","DOI":"10.3791\/59511"},{"key":"bibr26-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awr278"},{"key":"bibr27-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25743"},{"key":"bibr28-1352458521999651","unstructured":"R Core Team. R: A language and environment for statistical computing, 2013, http:\/\/www.r-project.org\/"},{"key":"bibr29-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1111\/cns.13266"},{"key":"bibr30-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2016-313772"},{"key":"bibr31-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20160721"},{"key":"bibr32-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2018-319208"},{"key":"bibr33-1352458521999651","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.114"}],"container-title":["Multiple Sclerosis Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1352458521999651","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1352458521999651","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1352458521999651","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:08:52Z","timestamp":1777694932000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1352458521999651"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,22]]},"references-count":33,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1177\/1352458521999651"],"URL":"https:\/\/doi.org\/10.1177\/1352458521999651","relation":{},"ISSN":["1352-4585","1477-0970"],"issn-type":[{"value":"1352-4585","type":"print"},{"value":"1477-0970","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,22]]}}}