Intracortical Lesions and Multiple Sclerosis Risk

In multiple sclerosis (MS), intracortical lesions (ICLs) are common and sometimes extensive but are not detectable by brain magnetic resonance imaging (MRI) scans in clinical use. An investigational MRI technique, double-inversion recovery (DIR), can reveal some ICLs. In this study, the authors explored whether DIR could improve on the sensitivity and specificity of current MRI criteria for MS risk stratification after a first demyelinating event. The current criteria are based on the presence of periventricular, juxtacortical, and infratentorial lesions. The derivation cohort was 80 patients with a first demyelinating episode who underwent brain and spinal cord MRI every 6 months for 2 years and then annually (median total follow-up, 55 mo…