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Gray matter imaging in multiple sclerosis: what have we learned?

Hanneke E Hulst1, Jeroen J G Geurts

  • 1Department of Radiology, VU University Medical Centre, PO Box 7057, 1007 MB, Amsterdam, The Netherlands. he.hulst@vumc.nl

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Area of Science:

  • Neuroscience
  • Radiology
  • Pathology

Background:

  • Historically, white matter pathology dominated multiple sclerosis (MS) research.
  • Gray matter involvement in MS was underestimated due to suboptimal histological techniques and imaging limitations.
  • Recent advancements have highlighted the significance of gray matter damage in MS progression.

Purpose of the Study:

  • To review the current understanding of imaging gray matter damage in MS.
  • To discuss the evolution of imaging techniques for detecting MS-related gray matter pathology.
  • To explore the clinical implications of improved gray matter imaging in MS.

Main Methods:

  • Review of scientific literature on MS gray matter pathology and imaging.
  • Analysis of conventional and advanced magnetic resonance imaging (MRI) techniques.
  • Correlation of imaging findings with clinical manifestations of MS.

Main Results:

  • Gray matter lesions are frequent, extensive, and more severe in progressive MS phases.
  • Histopathology of gray matter lesions differs from white matter lesions in MS.
  • Advanced MRI techniques significantly enhance the detection of cortical and subcortical MS damage.

Conclusions:

  • Gray matter pathology is a critical component of MS, impacting disease progression and clinical outcomes.
  • Improved imaging of gray matter damage in MS opens new avenues for research and patient management.
  • Future developments in MRI hold promise for further elucidating the role of gray matter in MS.