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Updated: Nov 2, 2025
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Mild gray matter atrophy in patients with long-standing multiple sclerosis and favorable clinical course
Rosa Cortese1, Marco Battaglini1, Francesca Parodi1
1Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
Abstract:
The mechanisms responsible for the favorable clinical course in multiple sclerosis (MS) remain unclear. In this longitudinal study, we assessed whether magnetic resonance imaging (MRI)-based changes in focal and diffuse brain damage are associated with a long-term favorable MS diseases course. We found that global brain and gray matter (GM) atrophy changes were milder in MS patients with long-standing disease (⩾30 years from onset) and favorable (no/minimal disability) clinical course than in sex-age-matched disable MS patients, independently of lesions accumulation. Data showed that different trajectories of volume changes, as reflected by mild GM atrophy, may characterize patients with long-term favorable evolution.
Insights
Understanding the favorable clinical course in multiple sclerosis (MS) is key. This study found milder brain and gray matter atrophy in long-term MS patients with minimal disability, suggesting distinct volume change patterns characterize favorable disease evolution.
Area of Science:
- Neuroscience
- Radiology
Background:
- The mechanisms behind a favorable clinical course in multiple sclerosis (MS) are not fully understood.
- Magnetic resonance imaging (MRI) is crucial for assessing brain changes in MS.
Purpose of the Study:
- To investigate the association between MRI-detected brain damage and long-term favorable MS disease course.
- To determine if changes in focal and diffuse brain damage correlate with sustained mild disability in MS.
Main Methods:
- A longitudinal study design was employed.
- MRI was used to assess focal and diffuse brain damage.
- Gray matter (GM) atrophy and global brain atrophy were measured.
Main Results:
- MS patients with long-standing disease (≥30 years) and favorable clinical course showed milder global brain and GM atrophy compared to disabled MS patients.
- These findings were independent of lesion accumulation.
- Distinct volume change trajectories, particularly mild GM atrophy, were observed in patients with a favorable long-term disease evolution.
Conclusions:
- Milder gray matter atrophy may characterize patients with a favorable long-term multiple sclerosis disease course.
- Brain atrophy patterns, rather than just lesion load, are important indicators of MS disease progression and clinical outcomes.
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