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Updated: Jun 22, 2025
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Decoding Gray Matter Involvement in Multiple Sclerosis via Imaging
Robert Zivadinov1, Ferdinand Schweser1, Dejan Jakimovski2
1Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA.
Abstract:
Multiple sclerosis (MS) is increasingly understood not only as a white matter disease but also involving both the deep and cortical gray matter (GM). GM pathology in people with MS (pwMS) includes the presence of lesions, leptomeningeal inflammation, atrophy, altered iron concentration, and microstructural changes. Studies using 7T and 3T MR imaging with optimized protocols established that GM damage is a principal driver of disease progression in pwMS. Future work is needed to incorporate the assessment of these GM imaging biomarkers into the clinical workup of pwMS and the assessment of treatment efficacy.
Insights
Multiple sclerosis involves gray matter (GM) damage, not just white matter. This gray matter pathology significantly drives disease progression in people with MS.
Area of Science:
- Neuroimaging
- Neurology
- Pathology
Background:
- Multiple sclerosis (MS) is traditionally viewed as a white matter disease.
- Emerging evidence highlights significant gray matter (GM) involvement in MS pathology.
- Gray matter damage contributes to disease progression in people with MS (pwMS).
Purpose of the Study:
- To summarize the understanding of gray matter pathology in MS.
- To emphasize the role of GM damage as a driver of MS progression.
- To advocate for the clinical integration of GM imaging biomarkers.
Main Methods:
- Review of studies utilizing advanced Magnetic Resonance (MR) imaging techniques (7T and 3T).
- Analysis of optimized MR imaging protocols for detecting GM changes.
- Synthesis of findings on GM pathology in people with MS.
Main Results:
- Gray matter pathology in MS includes lesions, leptomeningeal inflammation, atrophy, and microstructural changes.
- Advanced MR imaging confirms GM damage as a principal driver of disease progression.
- GM imaging biomarkers are crucial for assessing disease severity and treatment response.
Conclusions:
- Gray matter pathology is a critical component of multiple sclerosis.
- Advanced neuroimaging techniques reveal the extent of GM damage in MS.
- Incorporating GM imaging biomarkers into clinical practice is essential for managing MS.
