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Radiological manifestation of smoldering disease

Chronic active lesions, including SELs and PRLs, represent the evolution of acute lesions via CNS resident processes.1–4 They occur early and throughout the disease course.1,2

Chronic active lesions undergo ongoing demyelination; may slowly expand, change shape or fuse with neighboring lesions4–7

Chronic active WM lesion4

Detecting smoldering disease clinically during routine clinical practice

Multimodal approach to uncover disability accumulation resulting from smoldering disease in MS

For more information about Acute and Smoldering Inflammation, click on this link:

Acute & Smoldering Neuroinflammation

9HPT, 9-hole peg test; BVL, brain volume loss; CDI, confirmed disability improvement; CDW, confirmed disability worsening; EDSS, Expanded Disability Status Scale; Gd+, gadolinium-enhancing; MSFC, multiple sclerosis functional composite; NEDA, no evidence of disease activity; PROs, patient-reported outcomes; SDMT, symbol digit modalities test; T25FW, timed 25-foot walk;CAL, chronic active lesion; CNS, central nervous system; PRL, paramagnetic rim lesion; SEL, slowly expanding lesion; WM, white matter.

BICAMS=Brief International Cognitive Assessment for MS; CSF=cerebrospinal fluid; CVLT-II=California Verbal Learning Test Second Edition; CXCL13=CXC motif chemokine ligand 13; GFAP=glial fibrillary acidic protein; HADS=Hospital Anxiety and Depression Scale; MFIS=Modified Fatigue Impact Scale; MSIS=MS Impact scale; MSNQ=MS Neuropsychological Questionnaire; MSQoL-54=Multiple Sclerosis Quality of Life-54; NfL=neurofilament light; PRLs=paramagnetic rim lesions; SDMT=symbol digit modalities test; SELs=slowly expanding lesions.

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