Gray matter involvement in multiple sclerosis

@article{Pirko2007GrayMI,
  title={Gray matter involvement in multiple sclerosis},
  author={I. Pirko and Claudia F. Lucchinetti and Subramaniam Sriram and Rohit Bakshi},
  journal={Neurology},
  year={2007},
  volume={68},
  pages={634 - 642}
}
Gray matter (GM) involvement is detected even in the earliest stages of multiple sclerosis (MS), and GM atrophy occurs at a faster rate than white matter (WM) atrophy early in the disease course. Studies published to date establish that 1) GM involvement and in particular cortical demyelination can be extensive in MS; 2) GM pathology may occur in part independently of WM lesion formation; 3) a primarily GM-related process may be the earliest manifestation of MS; 4) GM involvement is associated… 

Figures from this paper

Gray Matters in Multiple Sclerosis: Cognitive Impairment and Structural MRI
TLDR
An overview of CI and GM damage assessed by structural brain MRI is provided, suggesting that probably WM abnormalities alone cannot fully explain the extent of clinical symptoms in MS, including CI.
Predicting the development of multiple sclerosis
TLDR
Assessing both GM atrophy and GM lesion loads has the potential to provide complementary information, albeit with the caveat that the relationship between cortical lesions and atrophy in the early phases of the disease has yet to be elucidated.
MRI Analysis to Detect Gray Matter Tissue Loss in Multiple Sclerosis
TLDR
An automated algorithm that segmented GM and WM in magnetic resonance images (MRI) and measured the normalized GM volume found that the rate of GM atrophy increased in a stage-dependent manner, which was similar to that of whole brain atrophy.
Gray matter atrophy correlates with MS disability progression measured with MSFC but not EDSS
Grey matter lesions in MS
TLDR
The available MRI data obtained on large cohorts of patients indicate that cortical lesions can be detected early in the disease course, sometimes even before the appearance of WM lesions, and correlate with the severity of physical disability and cognitive impairment, and with the evolution of the disease toward the secondary progressive phase.
ADVANCES IN THE NEUROPATHOLOGY OF MULTIPLE SCLEROSIS: EVOLVING PATHOGENIC INSIGHTS
The advent of more sophisticated histologic and molecular tools to study multiple sclerosis (MS) pathology has contributed to evolving concepts regarding disease initiation and progression. MS
Regional Distribution and Evolution of Gray Matter Damage in Different Populations of Multiple Sclerosis Patients
TLDR
GM atrophy and lesions appear to be different signatures of cortical disease in MS having in common overlapping spatio-temporal distribution patterns, but the correlation between focal and diffuse damage is only moderate and more evident in the early phase of the disease.
Cortical lesions in multiple sclerosis
TLDR
This Review provides a summary of the main histopathological and MRI findings with regard to cortical lesions in MS, and indicates that increasing understanding of cortical lesions has increased the knowledge of MS pathobiology.
The neuropathological basis of clinical progression in multiple sclerosis
TLDR
The contributions that the various types of pathology are likely to make to the increasing neurological deficit in MS are reviewed.
Brain atrophy correlates with functional outcome in a murine model of multiple sclerosis
...
...

References

SHOWING 1-10 OF 63 REFERENCES
Early development of multiple sclerosis is associated with progressive grey matter atrophy in patients presenting with clinically isolated syndromes.
TLDR
It is suggested that progressive grey matter, but not white matter, atrophy is seen in the earliest clinically observable stages of relapse onset multiple sclerosis, and this is only moderately related to lesion accumulation.
Gray and white matter volume changes in early RRMS
TLDR
Increasing gray matter but not white matter (WM) atrophy was observed early in the clinical course of relapsing-remitting multiple sclerosis, and fluctuations in inflammatory WM lesions appear to be related to volume changes in WM over this time period.
Cortical demyelination and diffuse white matter injury in multiple sclerosis.
TLDR
Global brain pathology in multiple sclerosis is analysed, focusing on the normal-appearing white matter (NAWM) and the cortex, to suggest that multiple sclerosis starts as a focal inflammatory disease of the CNS, which gives rise to circumscribed demyelinated plaques in the white matter.
Cortical lesions in multiple sclerosis: combined postmortem MR imaging and histopathology.
TLDR
In contrast to WM lesions and mixed GM-WM lesions, intracortical lesions remain largely undetected with current MR imaging resolution.
Evidence of early cortical atrophy in MS
TLDR
The extent of the changes suggests that neocortical GM pathology may occur early in the course of the disease in both RR and PP MS patients and contribute significantly to neurologic impairment.
Focal thinning of the cerebral cortex in multiple sclerosis.
TLDR
In vivo measurement of cortical thickness is concluded to be feasible in patients suffering from multiple sclerosis, revealing focal cortical thinning beside an overall reduction of the cortical thickness with disease progression.
Brain atrophy in clinically early relapsing-remitting multiple sclerosis.
TLDR
The results indicate that significant brain atrophy, affecting both grey and white matter, occurs early in the clinical course of multiple sclerosis.
Brain metabolite changes in cortical grey and normal-appearing white matter in clinically early relapsing-remitting multiple sclerosis.
TLDR
The results indicate that metabolite changes in NAWM and CGM can be detected early in the clinical course of multiple sclerosis, and that some of these changes relate to clinical status.
...
...