New paradigm in the diagnosis and treatment of multiple sclerosis

Focal chronic active lesions (CALs) play a key role in the increase in MS disability, which is due to smoldering neuroinflammation in the central nervous system. This inflammation, often behind an intact blood-brain barrier, is resistant to common DMTs. In vivo visualization as paramagnetic rim lesions (PRLs) serves as a biomarker. PRLs have been included in the MS diagnostic criteria at
and direct the focus towards therapies against chronic inflammation.