The prevalence of paramagnetic rim lesions in multiple sclerosis: A systematic review and meta-analysis.

<h4>Background</h4>Recent findings from several studies have shown that paramagnetic rim lesions identified using susceptibility-based MRI could represent potential diagnostic and prognostic biomarkers in multiple sclerosis (MS). Here, we perform a systematic review and meta-analysis of...

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Autores principales:	Koy Chong Ng Kee Kwong, Daisy Mollison, Rozanna Meijboom, Elizabeth N York, Agniete Kampaite, Michael J Thrippleton, Siddharthan Chandran, Adam D Waldman
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/cf8548845c894776844e0ba31c17e420
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spelling	oai:doaj.org-article:cf8548845c894776844e0ba31c17e4202021-12-02T20:14:46ZThe prevalence of paramagnetic rim lesions in multiple sclerosis: A systematic review and meta-analysis.1932-620310.1371/journal.pone.0256845https://doaj.org/article/cf8548845c894776844e0ba31c17e4202021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0256845https://doaj.org/toc/1932-6203<h4>Background</h4>Recent findings from several studies have shown that paramagnetic rim lesions identified using susceptibility-based MRI could represent potential diagnostic and prognostic biomarkers in multiple sclerosis (MS). Here, we perform a systematic review and meta-analysis of the existing literature to assess their pooled prevalence at lesion-level and patient-level.<h4>Methods</h4>Both database searching (PubMed and Embase) and handsearching were conducted to identify studies allowing the lesion-level and/or patient-level prevalence of rim lesions or chronic active lesions to be calculated. Pooled prevalence was estimated using the DerSimonian-Laird random-effects model. Subgroup analysis and meta-regression were performed to explore possible sources of heterogeneity. PROSPERO registration: CRD42020192282.<h4>Results</h4>29 studies comprising 1230 patients were eligible for analysis. Meta-analysis estimated pooled prevalences of 9.8% (95% CI: 6.6-14.2) and 40.6% (95% CI: 26.2-56.8) for rim lesions at lesion-level and patient-level, respectively. Pooled lesion-level and patient-level prevalences for chronic active lesions were 12.0% (95% CI: 9.0-15.8) and 64.8% (95% CI: 54.3-74.0), respectively. Considerable heterogeneity was observed across studies (I2>75%). Subgroup analysis revealed a significant difference in patient-level prevalence between studies conducted at 3T and 7T (p = 0.0312). Meta-regression analyses also showed significant differences in lesion-level prevalence with respect to age (p = 0.0018, R2 = 0.20) and disease duration (p = 0.0018, R2 = 0.48). Other moderator analyses demonstrated no significant differences according to MRI sequence, gender and expanded disability status scale (EDSS).<h4>Conclusion</h4>In this study, we show that paramagnetic rim lesions may be present in an important proportion of MS patients, notwithstanding significant variation in their assessment across studies. In view of their possible clinical relevance, we believe that clear guidelines should be introduced to standardise their assessment across research centres to in turn facilitate future analyses.Koy Chong Ng Kee KwongDaisy MollisonRozanna MeijboomElizabeth N YorkAgniete KampaiteMichael J ThrippletonSiddharthan ChandranAdam D WaldmanPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 9, p e0256845 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Koy Chong Ng Kee Kwong Daisy Mollison Rozanna Meijboom Elizabeth N York Agniete Kampaite Michael J Thrippleton Siddharthan Chandran Adam D Waldman The prevalence of paramagnetic rim lesions in multiple sclerosis: A systematic review and meta-analysis.
description	<h4>Background</h4>Recent findings from several studies have shown that paramagnetic rim lesions identified using susceptibility-based MRI could represent potential diagnostic and prognostic biomarkers in multiple sclerosis (MS). Here, we perform a systematic review and meta-analysis of the existing literature to assess their pooled prevalence at lesion-level and patient-level.<h4>Methods</h4>Both database searching (PubMed and Embase) and handsearching were conducted to identify studies allowing the lesion-level and/or patient-level prevalence of rim lesions or chronic active lesions to be calculated. Pooled prevalence was estimated using the DerSimonian-Laird random-effects model. Subgroup analysis and meta-regression were performed to explore possible sources of heterogeneity. PROSPERO registration: CRD42020192282.<h4>Results</h4>29 studies comprising 1230 patients were eligible for analysis. Meta-analysis estimated pooled prevalences of 9.8% (95% CI: 6.6-14.2) and 40.6% (95% CI: 26.2-56.8) for rim lesions at lesion-level and patient-level, respectively. Pooled lesion-level and patient-level prevalences for chronic active lesions were 12.0% (95% CI: 9.0-15.8) and 64.8% (95% CI: 54.3-74.0), respectively. Considerable heterogeneity was observed across studies (I2>75%). Subgroup analysis revealed a significant difference in patient-level prevalence between studies conducted at 3T and 7T (p = 0.0312). Meta-regression analyses also showed significant differences in lesion-level prevalence with respect to age (p = 0.0018, R2 = 0.20) and disease duration (p = 0.0018, R2 = 0.48). Other moderator analyses demonstrated no significant differences according to MRI sequence, gender and expanded disability status scale (EDSS).<h4>Conclusion</h4>In this study, we show that paramagnetic rim lesions may be present in an important proportion of MS patients, notwithstanding significant variation in their assessment across studies. In view of their possible clinical relevance, we believe that clear guidelines should be introduced to standardise their assessment across research centres to in turn facilitate future analyses.
format	article
author	Koy Chong Ng Kee Kwong Daisy Mollison Rozanna Meijboom Elizabeth N York Agniete Kampaite Michael J Thrippleton Siddharthan Chandran Adam D Waldman
author_facet	Koy Chong Ng Kee Kwong Daisy Mollison Rozanna Meijboom Elizabeth N York Agniete Kampaite Michael J Thrippleton Siddharthan Chandran Adam D Waldman
author_sort	Koy Chong Ng Kee Kwong
title	The prevalence of paramagnetic rim lesions in multiple sclerosis: A systematic review and meta-analysis.
title_short	The prevalence of paramagnetic rim lesions in multiple sclerosis: A systematic review and meta-analysis.
title_full	The prevalence of paramagnetic rim lesions in multiple sclerosis: A systematic review and meta-analysis.
title_fullStr	The prevalence of paramagnetic rim lesions in multiple sclerosis: A systematic review and meta-analysis.
title_full_unstemmed	The prevalence of paramagnetic rim lesions in multiple sclerosis: A systematic review and meta-analysis.
title_sort	prevalence of paramagnetic rim lesions in multiple sclerosis: a systematic review and meta-analysis.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/cf8548845c894776844e0ba31c17e420
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The prevalence of paramagnetic rim lesions in multiple sclerosis: A systematic review and meta-analysis.

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