Introduction Although multiple sclerosis (MS) has been classically regarded as a white matter (WM) disease of the central nervous system (CNS), pathological studies have shown the presence of MS-related damage in the gray matter (GM) of MS patients. Cortical GM lesions have been distinguished in mixed WM–GM lesions (type I), and purely intracortical lesions (types II, III, and IV). In addition to the neocortex, demyelination can also be found in the GM of the thalamus, basal ganglia, hypothalamus, hippocampus, cerebellum, and spinal cord. A recent study suggested that meningeal inflammation may be a cause for subpial demyelination. MS-related GM pathology is associated with neuronal injury, including neuritic swelling, as well as dendritic and axonal transections. Consistently with pathological studies, recent magnetic resonance imaging (MRI) studies have shown the involvement of the GM in MS, in terms of focal lesion, “diffuse” tissue abnormalities, and irreversible tissue loss (i.e., atrophy). These studies have also shown that GM damage affects the cortex and deep nuclei in the brain as well as the spinal cord, is present from the earliest clinical stage of the disease, and is at least partially independent of the WM burden of the disease. This chapter summarizes the main results obtained from the use of conventional and modern quantitative MR-based techniques – namely, magnetization transfer (MT) MRI, diffusion-weighted (DW) MRI, and proton MR spectroscopy (1H-MRS) – for the assessment of GM pathology in patients with MS.
|Title of host publication||Multiple Sclerosis: Recovery of Function and Neurorehabilitation|
|Publisher||Cambridge University Press|
|Number of pages||7|
|ISBN (Print)||9780511781698, 9780521888325|
|Publication status||Published - Jan 1 2010|
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