Abstract
SUMMARY: Recent pathologic and MR imaging studies have challenged the classic view of MS as a chronic inflammatory-demyelinating condition affecting solely the WM of the central nervous system. Indeed, an involvement of the GM has been shown to occur from the early stages of the disease, to progress with time, and to be only moderately correlated with the extent of WM injury. In this review, we summarize how advances in MR imaging technology and methods of analysis are contributing to ameliorating the detection of focal lesions and to quantifying the extent of “occult” pathology and atrophy, as well as to defining the topographic distribution of such changes in the GM of patients with MS. These advances, combined with the imaging of brain reorganization occurring after tissue injury, should ultimately result in an improved understanding and monitoring of MS clinical manifestations and evolution, either natural or modified by treatment.
Abbreviations
- Cereb
- cerebellum
- Cho
- choline
- CIS
- clinically isolated syndromes
- DIR
- double inversion recovery
- DTI
- diffusion tensor imaging
- EDSS
- Expanded Disability Status Scale
- FA
- fractional anisotropy
- FLAIR
- fluid-attenuated inversion recovery
- fMRI
- functional MR imaging
- GM
- gray matter
- L
- left
- MD
- mean diffusivity
- MS
- multiple sclerosis
- MT
- magnetization transfer
- MTR
- magnetization transfer ratio
- NAA
- N-acetylaspartate
- NAWM
- normal-appearing white matter
- PM
- premotor cortex
- PPMS
- primary-progressive MS
- R
- right
- RRMS
- relapsing-remitting MS
- RT
- relaxation time
- SII
- secondary sensorimotor cortex
- SMA
- supplementary motor area
- SMC
- sensorimotor cortex
- SPM
- statistical parametric mapping
- SPMS
- secondary-progressive MS
- Thal
- thalamus
- WM
- white matter
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