Patterns of Lesion Volume Evolution in Multiple Sclerosis: Associations with Microstructural Change and Neuroaxonal Damage

Motivation: Measuring lesion volume evolution in Multiple Sclerosis patients is fundamental to assessing disease progression and clinical worsening. Goal(s): Classify white matter lesions based on their volume evolution and investigate whether they are associated with microstructural changes and neuroaxonal damage. Approach: Lesion volume evolution was assessed using the Jacobian methods applied to FLAIR MRI images; microstructural changes were quantified using T1 relaxometry from MP2RAGE, and neuroaxonal damage was assessed via serum neurofilament light chain levels. Results: Our findings revealed distinct lesion clusters based on volume change trajectories, with significant associations between these clusters and MRI and serum markers of tissue damage. Impact: These findings can reflect the importance of chronic neurodegenerative processes within MS lesions and provide a foundation for further investigation into the mechanisms of disease progression and clinical worsening in pwMS.