Related Experiment Video
Updated: Jun 24, 2025

Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Subtypes and location of (juxta)cortical lesions relate to cognitive dysfunction in people with multiple sclerosis
Eva A Krijnen1,2, Rose-Marie Kouwenhoven1, Samantha Noteboom1
1MS Center Amsterdam, Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC location VUmc, Amsterdam, The Netherlands.
Background:
Cortical lesion subtypes' occurrence and distribution across networks may shed light on cognitive impairment (CI) in multiple sclerosis (MS).
Methods:
In 332 people with MS, lesions were classified as intracortical, leukocortical or juxtacortical based on artificially generated double inversion-recovery images.
Results:
CI-related leukocortical lesion count increases were greatest within sensorimotor and cognitive networks (p < 0.001). Only intracortical lesion count could distinguish between cognitive groups (p = 0.024). Effect sizes were two- to four-fold larger than differences between MS phenotypes.
Conclusion:
In CI-MS, leukocortical lesions predominate, whereas intracortical lesions distinguish cognitive groups. Lesions' grey matter (GM) involvement might be decisive for cognition in MS, surpassing overall disease burden.
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