The Prognostic Value of Paramagnetic Rim Lesions in People With Multiple Sclerosis.

Cohort studyNeurology· Sep 2026

The Prognostic Value of Paramagnetic Rim Lesions in People With Multiple Sclerosis.

Markus Lauerer, Cui Ci Voon, Julian McGinnis … Mark Mühlau

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Prediction Models & Risk ScoresCohort studyPrognosis

Paramagnetic rim lesions raise risk of disability progression independent of relapse in multiple sclerosis

The Prognostic Value of Paramagnetic Rim Lesions in People With Multiple Sclerosis.

Markus Lauerer … Mark Mühlau

Neurology · Sep 2026

Background

Paramagnetic rim lesions (paramagnetic rim lesions) have been established as a radiologic surrogate for chronic active inflammation in multiple sclerosis (multiple sclerosis).

Methods

From a large, ongoing single-center cohort study, people with multiple sclerosis were included according to the availability of susceptibility-sensitive MRI.

n = 862 participants

Results

Paramagnetic rim lesions raise risk of disability progression without relapses

aHR 1.80 (95% CI 1.10 to 2.80)

null 1

1.10

2.80

CI excludes the null - significant

More results

Among 862 participants (mean age 40.3 years, 64.7% female), 395 (45.8%) had at least 1 paramagnetic rim lesions.

More results

Exploratory subgroup analyses showed increased markers of chronic intrathecal inflammation in individuals with paramagnetic rim lesions as well as a correlation between the number of paramagnetic rim lesions and future brain atrophy (PBVC: β = -0.012%, 95% CI -0.018% to -0.005%; p < 0.001).

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Conclusion

These findings emphasize their potential as a prognostic biomarker for risk stratification in multiple sclerosis.

The Prognostic Value of Paramagnetic Rim Lesions in People With Multiple Sclerosis.

The Prognostic Value of Paramagnetic Rim Lesions in People With Multiple Sclerosis.

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