title: Lesion-to-ventricle distance and other risk factors for the persistence of newly formed black holes in relapsing-remitting multiple sclerosis.
abstract: BACKGROUND
  Progenitor cells from the subventricular zone (SVZ) of the lateral ventricles are assumed to contribute to remyelination and resolution of black holes (BHs) in multiple sclerosis (MS). This process may depend on the distance between the lesion and the SVZ.
  
  
  OBJECTIVE
  The objective of this paper is to investigate the relationship between lesion-to-ventricle (LV) distance and persistence of new BHs.
  
  
  METHODS
  We analysed the magnetic resonance images (MRIs) of 289 relapsing-remitting (RR) MS patients, obtained during a multi-centre, placebo-controlled phase II trial over one year.
  
  
  RESULTS
  Overall, 112/289 patients showed 367 new BHs at the beginning of the trial. Of these, 225 were located in 94/112 patients at the level of the lateral ventricles on axial MRIs and included in this analysis. In total, 86/225 (38%) BHs persisted at month 12. LV distance in persistent BHs (PBHs) was not longer than in transient BHs. In fact PBHs tended to be closer to the SVZ than transient BHs. A generalised linear mixed multivariate model adjusted for BHs clustered within a patient and including patient- as well as lesion-specific factors revealed size, ring contrast enhancement, and shorter LV distance as independent predictors for BH persistence.
  
  
  CONCLUSIONS
  Location of BHs close to the lateral ventricles does not appear to favourably influence the resolution of new BHs in RRMS.
authors.affiliation: Department of Neurology, University Hospital Basel, Switzerland.
authors.forename: Athina
authors.initials: A
authors.lastname: Papadopoulou
authors.forename: Milena
authors.initials: M
authors.lastname: Menegola
authors.forename: Jens
authors.initials: J
authors.lastname: Kuhle
authors.forename: Sreeram V
authors.initials: SV
authors.lastname: Ramagopalan
authors.forename: Marcus
authors.initials: M
authors.lastname: D'Souza
authors.forename: Till
authors.initials: T
authors.lastname: Sprenger
authors.forename: Ernst-Wilhelm
authors.initials: EW
authors.lastname: Radue
authors.forename: Ludwig
authors.initials: L
authors.lastname: Kappos
authors.forename: Özgür
authors.initials: Ö
authors.lastname: Yaldizli
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D002552:Cerebral Ventricles / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000473:pathology*; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D012307:Risk Factors
keywords: Multiple sclerosis; black holes; lesion-to-ventricle distance; magnetic resonance imaging; subventricular zone