A, Lesion growth trajectories from the time of the first abnormal MR imaging finding in presymptomatic patients with progressive (n = 23, red) versus arrested (n = 13, blue) CALD. Lesion volume increased 2.5× per month (fold change β = 2.49 [95% CI, 2.10–2.89], P < .001) in the patients with progressive CALD. B, In the cohort of patients with an initial LS ≤ 2 (restricted cohort; n = 19 progressive, n = 4 arrested), lesion growth was similar (β = 2.54 [95% CI, 2.04–3.04], P < .001) for the patients with progressive CALD.