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This is a recent article. They have followed several patients by SWI MRI and they have found that lesion development begins with the contraction of a capillar vein.

New insight in perivenular lesion formation in MS on weekly susceptibility weighted images
https://www.researchgate.net/profile/Si ... a8495e.pdf

SYNOPSIS

In this paper, we take advantage of a unique longitudinal MRI dataset acquired at weekly intervals on untreated multiple sclerosis patients.

We study the signal dynamics of relapsing-remitting multiple sclerosis lesions on SWI MRI and show, thanks to an unsupervised spatiotemporal clustering algorithm, that specific signal intensity behaviors exist between the veins and the lesions that are synchronous with contrast enhancement on gadolinium-enhanced T1-weighted MRI.

Our study shows that vein narrowing depicted on SWI is an early event that appears to precede blood-brain barrier disruption signified by contrast-enhancement.

Hi Frodo,

This article is a GREAT find! Very intriguing and it surely indicates a role for the vascular system in MS. Plus it further points to the fact that neurologists could benefit from listening to, learning from, and collaborating with vascular specialists.

Thanks for posting it!

M.A.