Introduction Over the past decade, conventional and modern structural magnetic resonance imaging (MRI) techniques have been extensively used to study patients with multiple sclerosis (MS) to increase the understanding of the mechanisms responsible for the accumulation of irreversible disability. In detail, the application of these techniques has provided important insights into the pathobiology of the disease, by showing that: (1) MS-related damage is not restricted to T2-visible lesions, but it involves diffusely the normal-appearing white matter (NAWM) and gray matter (GM); (2) the neurodegenerative component of the disease is not a late phenomenon and it is not completely driven by inflammatory demyelination; and (3) axonal damage makes an important contribution to the clinical manifestations of the disease. Despite this, however, the magnitude of the correlation between MRI and clinical findings remained suboptimal. Among the reasons for such a discrepancy, the variable effectiveness of reparative and recovery mechanisms following MS-related tissue damage has been suggested to have a role. Among these, brain plasticity is a well-known feature of the human brain, which is likely to have several different substrates (including increased axonal expression of sodium channels, synaptic changes, increased recruitment of parallel existing pathways or “latent” connections, and reorganization of distant sites), and which might have a major adaptive role in limiting the functional consequences of axonal loss in MS.
|Title of host publication||Multiple Sclerosis: Recovery of Function and Neurorehabilitation|
|Publisher||Cambridge University Press|
|Number of pages||10|
|ISBN (Print)||9780511781698, 9780521888325|
|Publication status||Published - Jan 1 2010|
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