ClinicalTrials.gg
RecruitingNCT07444047Updated Jun 1, 2026

MRI-Based Lesion Differentiation in Older Patients With Multiple Sclerosis

An observational study in Multiple Sclerosis (MS) and Cerebral Small Vessel Diseases, sponsored by Oslo University Hospital. Recruiting at 1 site in Norway. Open to participants aged 50 Years to 80 Years. Per ClinicalTrials.gov, last updated 2026-06-01.

Sponsored by Oslo University Hospital · Observational

From the registry’s dates

  • Started May 2026; still recruiting 6 months later.
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
1,000
Ages
50 Years to 80 Years
Sex
All
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Study summary

This study investigates whether an advanced MRI technique called Quantitative Susceptibility Mapping (QSM) can improve the differentiation of white matter lesions in people aged 50-70 years with multiple sclerosis (MS). In older individuals with MS, white matter changes seen on MRI may be related to MS or to other types of white matter changes, most commonly age-related changes or chronic small vessel disease. These conditions can appear similar on conventional MRI scans, making interpretation challenging.

Participants will undergo routine clinical MRI, including a short additional QSM sequence, as well as brief cognitive and physical assessments. A comparison group with cerebral small vessel disease will also be included.

The goal of the study is to determine whether QSM can provide more precise lesion characterization and support more accurate clinical interpretation of MRI findings in older patients with MS.

Read the detailed description

Magnetic resonance imaging (MRI) is central to the diagnosis and monitoring of multiple sclerosis (MS). In individuals above 50 years of age, interpretation of white matter lesions becomes increasingly complex because lesions visible on conventional T2-weighted and FLAIR MRI may reflect MS-related demyelination, chronic cerebral small vessel disease (cSVD), or nonspecific age-related white matter changes. Conventional MRI has limited specificity in differentiating between these entities, which may complicate assessment of disease activity and progression.

Quantitative Susceptibility Mapping (QSM) is an advanced MRI technique that quantifies tissue magnetic susceptibility and provides complementary information to conventional imaging. Differences in susceptibility characteristics may reflect underlying tissue composition and microstructural properties, potentially allowing improved differentiation between demyelinating and vascular white matter lesions.

This prospective observational cohort study includes individuals aged 50-70 years with established MS undergoing routine clinical MRI follow-up, as well as an age-comparable cohort with clinical and radiological evidence of cSVD. Participants with MS will undergo longitudinal follow-up through routine clinical MRI and clinical assessments, whereas participants in the cSVD cohort will undergo a single study visit including MRI and standardized clinical testing. MRI examinations include standard clinical sequences with the addition of a short QSM acquisition. Clinical assessment includes brief standardized measures of cognitive processing speed, executive function, and physical function performed in conjunction with clinical visits.

Imaging analyses will focus on lesion-level and participant-level susceptibility characteristics and their distribution patterns across cohorts. Associations between QSM-derived measures and clinical function will be explored. The study is designed to evaluate the diagnostic utility and clinical relevance of QSM-based lesion characterization in older individuals with MS.

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Conditions studied

  • Multiple Sclerosis (MS)
  • Cerebral Small Vessel Diseases

Keywords

  • Quantitative Susceptibility Mapping
  • QSM
  • White Matter Lesions
  • MRI
  • Lesion Differentiation
  • Aging
  • Neuroimaging
  • Demyelination
  • Small vessel Disease
03

In context

Multiple Sclerosis

3,264 studies on the registry are indexed under Multiple Sclerosis; 659 are open to participants now.

This study's planned enrollment of 1,000 is above the median of 100 across 970 observational studies indexed under Multiple Sclerosis.

Browse Multiple Sclerosis studies →

Lead sponsor

Oslo University Hospital is the lead sponsor of 834 studies on the registry; 149 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
50 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

The study population consists of two cohorts recruited at Oslo University Hospital.

The multiple sclerosis (MS) cohort includes participants aged 50-70 years with a clinically confirmed MS diagnosis enrolled in the AgeMS study, an ongoing longitudinal study of older individuals with MS. Eligible participants are invited to participate by letter. Participants undergo semiannual MRI examinations and standardized neurological, cognitive, and patient-reported assessments through 2030.

The cerebral small vessel disease (cSVD) control cohort includes patients aged 50-80 years with radiological evidence of hypertensive small vessel disease identified on MRI and recruited from the Stroke Unit. Eligible participants are approached during hospital admission and invited to participate. Eligible participants are approached during hospital admission and invited to participate. These participants undergo a single MRI session and standardized clinical testing.

Eligibility criteria

Inclusion Criteria Multiple Sclerosis (MS) cohort (AgeMS):

  • Age 50-70 years
  • Clinically confirmed diagnosis of multiple sclerosis
  • Participation in the AgeMS study at Oslo University Hospital

Inclusion Criteria Cerebral Small Vessel Disease (cSVD) control cohort:

  • Age 50-80 years
  • Radiological evidence of hypertensive small vessel disease on MRI
  • Good clinical recovery following (TIA), minor stroke, or stroke mimic diagnosis

Exclusion Criteria Multiple Sclerosis (MS) cohort:

  • MRI
  • Severe psychiatric comorbidity
  • Major functional disability unrelated to MS or CSVD

Exclusion Criteria Cerebral Small Vessel Disease (cSVD) control cohort:

  • MRI contraindications
  • Probable or definite cerebral amyloid angiopathy according to Boston criteria 2.0
  • Genetic or inflammatory vasculopathies
  • Persistent neurological deficits
  • Severe psychiatric comorbidity
  • Major functional disability unrelated to CSVD
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

TIA (transient ischaemic attack)

A “mini-stroke”: temporary stroke-like symptoms caused by reduced blood flow to part of the brain, spinal cord or eye, without signs of a new stroke on a scan.

Stroke symptoms need emergency care at once, even if they go away.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
1,000 participants (estimated)
Patient registry
No

Groups and cohorts

  • Aging Multiple Sclerosis (MS)

    Individuals aged 50-70 years with established multiple sclerosis undergoing routine clinical MRI follow-up including an additional QSM sequence.

  • Cerebral Small Vessel Disease (cSVD)

    Age-comparable individuals with clinical and radiological evidence of cerebral small vessel disease undergoing MRI including an additional QSM sequence.

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What researchers measure

Primary outcomes

  1. Lesion-Level Quantitative Susceptibility (ppb) Within T2 FLAIR Hyperintense White Matter Lesions at Baseline

    Quantitative susceptibility (ppb) will be measured using QSM within each segmented T2 FLAIR hyperintense white matter lesion. Lesion-level susceptibility values will be compared between lesions from the MS cohort and the cSVD cohort. Statistical analyses will account for clustering of multiple lesions within individual participants.

    Time frame: Baseline MRI (single MRI session for both cohorts)

Secondary outcomes

  1. Change From Baseline in Mean Lesion-Level Quantitative Susceptibility (ppb) Within T2 FLAIR Hyperintense White Matter Lesions in the MS Cohort

    Quantitative susceptibility (ppb) will be measured within each segmented lesion at each time point. The outcome is change from baseline in lesion-level susceptibility over time. Analyses will account for clustering of multiple lesions within participants.

    Time frame: From baseline through December 2030

  2. Association Between QSM-Derived Lesion Burden and Cognitive Composite z-Score

    Cognitive function will be summarized at each visit as a composite z-score derived from standardized tests of processing speed and executive function. QSM-derived lesion characteristics will be summarized at the participant level (e.g., burden of QSM-positive vs QSM-negative lesions and lesion volume metrics). Associations between participant-level QSM-derived lesion burden and cognitive composite z-score will be analyzed using regression models.

    Time frame: Baseline; repeated assessments in the MS cohort through December 2030

  3. Association Between QSM-Derived Lesion Burden and Physical Function Composite z-Score

    Physical function will be summarized at each visit as a composite z-score derived from standardized mobility and balance assessments. QSM-derived lesion characteristics will be summarized at the participant level (e.g., burden of QSM-positive vs QSM-negative lesions and lesion volume metrics). Associations between participant-level QSM-derived lesion burden and physical function composite z-score will be analyzed using regression models.

    Time frame: Baseline; repeated assessments through December 2030

  4. Association Between QSM-Derived Lesion Burden and Change From Baseline in Expanded Disability Status Scale (EDSS) Score

    Disability progression will be assessed as change from baseline in Expanded Disability Status Scale (EDSS) score during follow-up. QSM-derived lesion characteristics will be summarized at the participant level (e.g., burden of QSM-positive vs QSM-negative lesions and lesion volume metrics). Associations between participant-level QSM-derived lesion burden and EDSS change over time will be analyzed using mixed-effects models.

    Time frame: From baseline through December 2030

07

Study locations

1 of 1 sites recruiting
  • Oslo University Hospital
    Oslo, Oslo 0450, Norway
    Recruiting
    • Anna Therese Bjerkreim, MD PhD · Contactanthbj@ous-hf.no · 004797000219
    • Anna Therese Bjerkreim, MD PhD · Principal investigator
    • Lars Skattebøl, MD · Sub investigator
    • Elisabeth Gulowsen Celius, MD PhD · Sub investigator
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References and documents

Individual participant data

Plan to share: No — Individual participant data (IPD) will not be shared. The study involves sensitive clinical and neuroimaging data collected under specific ethical approvals and data protection regulations. In accordance with institutional policies and regulatory requirements, individual-level data cannot be made publicly available.

No publications or documents are linked to this record.

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Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started May 2026 (actual). Primary completion is estimated for Dec 2030, 55 months after the start.

Of 334 non-industry observational studies under Multiple Sclerosis, half reached primary completion within 36 months of starting (the median), counting those still running; a quarter within 13 and three quarters within 73. This study's planned 55 months is above that.

Counting every sponsor, half of 425 studies reached it within 41 months; a quarter within 15 and three quarters within 75.

How these figures are worked out, and which studies are left out of them.

Registered
Feb 19, 2026
First posted
Mar 2, 2026
StartActual
May 11, 2026
Primary completionEst.
Dec 31, 2030
CompletionEst.
Dec 31, 2031
Last update
Jun 1, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jun 1, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT07444047
Responsible party
Anna Bjerkreim (Postdoctoral Research Fellow, Oslo University Hospital) — Principal investigator
First posted
Mar 2, 2026
Start date
May 11, 2026
Primary completion
Dec 31, 2030 (estimated)
Completion
Dec 31, 2031 (estimated)
Last update
Jun 1, 2026

Study contacts

Anna Therese Bjerkreim, MD PhD
Contact
anthbj@ous-hf.no
004797000219
Lars Skattebøl, MD
Contact
lars@skattebol.com
004747299995

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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