Cortical imaging in multiple sclerosis: recent findings and 'grand challenges'

Area of Science:

• Neuroimaging
• Neurology
• Radiology

Background:

• Multiple sclerosis (MS) is a demyelinating disease affecting the central nervous system.
• Cortical damage, including lesions and atrophy, plays a significant role in MS progression and clinical outcomes.
• Accurate assessment of gray matter pathology is crucial for understanding MS pathogenesis and patient prognosis.

Purpose of the Study:

• To review recent advancements in cortical imaging techniques for multiple sclerosis.
• To highlight improvements in detecting and quantifying cortical damage in MS.
• To discuss the diagnostic and prognostic value of advanced imaging findings.

Main Methods:

• Review of recent literature on advanced neuroimaging techniques in MS.
• Focus on novel MRI pulse sequences and high-field strength imaging.
• Integration of histopathological findings with imaging data.

Main Results:

• New imaging techniques improve detection of cortical lesions and measurement of cortical atrophy.
• High-field strength MRI enhances visualization of cortical lesions, though subpial lesions remain challenging.
• Cortical and deep gray matter atrophy, along with cortical lesions, are valuable diagnostic and prognostic markers in MS.

Conclusions:

• Advanced imaging techniques are essential for visualizing and quantifying cortical damage in MS.
• These techniques improve the understanding of cognitive function and neural reorganization in MS.
• Continued development in neuroimaging promises further insights into MS pathology and patient management.