Topographical Variation of Iron‐Rimmed Lesions in the Multiple Sclerosis Brain and Spinal Cord: A Neuropathological Study

Annals of Neurology 2026 Open access

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Authors: Marco Pisa, Andrew Lockhart, Thomas Angell, Aimee Avery, Zaenab Dhari, Mary A. Bailey, Simon Hametner, Hal Drakesmith, Monika Höfer, Clara Limbaeck, Gabriele C DeLuca
DOI: 10.1002/ana.78113
Cited by: 2
References: 17

Abstract

Paramagnetic-rim lesions are a novel diagnostic marker in multiple sclerosis (MS) and are associated with poor prognosis due to their link with chronic inflammation and disease progression. Analyzing 46 postmortem MS cases, researchers found no iron rims in 67 white matter and 85 grey matter spinal cord lesions, despite most being active. In contrast, iron rims appeared in 20.9% of cortical and 80% of subcortical brain lesions, especially in deeper myelin-rich cortical layers. These findings highlight the regional variability of iron accumulation and have important implications for interpreting iron-rims in MS diagnosis, monitoring, and prognostication. ANN NEUROL 2026;99:730-736.

Fields of Study & Subjects

Multiple Sclerosis Research Studies Amyotrophic Lateral Sclerosis Research Autoimmune Neurological Disorders and Treatments

Publication details

Journal / source
Annals of Neurology
Publisher
Wiley
Volume
99
Issue
3
Pages
730–736
Publication date
18 January 2026
Language
EN