Imag(in)ing multiple sclerosis: Time to take better pictures

Area of Science:

• Neuroimaging
• Neurology
• Pathophysiology

Background:

• Magnetic resonance imaging (MRI) has identified extensive brain abnormalities in multiple sclerosis (MS) beyond traditional white matter lesions.
• This has led to the concept of MS as a whole-brain disease.

Purpose of the Study:

• To critically evaluate the implications of current MRI findings for understanding MS pathophysiology.
• To propose that principled imaging approaches can investigate the origins of whole-brain abnormalities in MS.

Main Methods:

• Review and critical analysis of existing MRI findings in multiple sclerosis.
• Argument for a shift in imaging research focus from description to etiological investigation.

Main Results:

• Current MRI findings suggest widespread brain involvement in MS.
• The significance of these findings for understanding disease pathophysiology remains debatable.

Conclusions:

• While MRI shows extensive brain abnormalities in MS, its implications for pathophysiology require careful consideration.
• Imaging research should aim to elucidate the genesis of these abnormalities, not merely document them.