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Updated: May 8, 2026
09:41
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Cortical Lesions Form Predominantly in Early Multiple Sclerosis
Batuhan Ayci1, Emma Dereskewicz1, Jonadab Dos Santos Silva1,2
1Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
Summary
Cortical lesions are common in early multiple sclerosis (MS), impacting disability. Most cortical lesion volume appears to form early in the disease, similar to established MS.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Cortical lesions are a common feature of multiple sclerosis (MS).
- Characterization of cortical lesions in early MS using high-resolution imaging has been limited.
- Cortical lesions are associated with neurological disability in MS patients.
Purpose of the Study:
- To characterize cortical lesions in individuals newly diagnosed with MS.
- To compare the lesion burden in early MS with a cohort of patients with longer disease duration.
- To investigate the relationship between cortical lesion burden and clinical outcomes in early MS.
Main Methods:
- Utilized 7 tesla (T) brain MRI for high-resolution imaging of cortical lesions in newly diagnosed MS patients (n=61).
- Employed T1-weighted and T2*-weighted images for cortical lesion identification and T1w images for non-cortical lesion segmentation.
- Compared findings with a previously studied NIH cohort (n=60) with longer disease duration using a similar MRI protocol.
Main Results:
- Cortical lesions were identified in 81% of newly diagnosed MS individuals, with subpial lesions in 75%.
- Cortical lesions constituted a median of 14% of total brain lesion volume, exceeding 50% in 21% of patients.
- Cortical lesion burden showed associations with poorer performance on the 9-hole peg test and Symbol Digit Modalities Test.
- Cortical lesion volume was similar between early and established MS cohorts, unlike non-cortical lesion volume which increased with disease duration.
Conclusions:
- Cortical lesions are highly prevalent in newly diagnosed MS and represent a significant portion of the overall lesion burden.
- The findings suggest that the majority of cortical lesion volume develops early in the course of MS.
- Cortical lesion characterization with 7T MRI provides valuable insights into early MS pathology and its relation to disability.
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