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BMC Neurology

, 12:9

Gray Matter Pathology in Multiple Sclerosis


The purpose of this special issue in BMC Neurology is to summarize advances in our understanding of the pathological, immunological, imaging and clinical concepts of gray matter GM pathology in patients with multiple sclerosis MS. Review articles by Lucchinetti and Popescu, Walker and colleagues, Hulst and colleagues and Horakova and colleagues summarize important recent advances in understanding GM damage and its implications to MS pathogenesis. They also raise a number of important new questions and outline comprehensive approaches to addressing those questions in years to come. In the last decade, the use of immunohistochemistry staining methods and more advanced imaging techniques to detect GM lesions, like double inversion recovery, contributed to a surge of studies related to cortical and subcortical GM pathology in MS. It is becoming more apparent from recent biopsy studies that subpial cortical lesions in early MS are highly inflammatory. The mechanisms responsible for triggering meningeal inflammation in MS patients are not yet elucidated, and they should be further investigated in relation to their role in initiating and perpetuating the disease process. Determining the role of antigens, environmental and genetic factors in the pathogenesis of GM involvement in MS is critical. The early involvement of cortical and subcortical GM damage in MS is very intriguing and needs to be further studied. As established in numerous cross-sectional and longitudinal studies, GM damage is a better predictor of physical disability and cognitive impairment than WM damage. Monitoring the evolution of GM damage is becoming an important marker in predicting future disease course and response to therapy in MS patients.

KeywordsMultiple sclerosis Gray matter Pathology Meningeal inflammation Cortical Subcortical MRI Double inversion recovery Atrophy Clinical Treatment AbbreviationsCNSCentral nervous system

DIRDouble inversion recovery

GMGray matter

MBPMyelin basic protein

MRIMagnetic resonance imaging

MSMultiple sclerosis

PLPProteolipid protein

WMWhite matter

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Autor: Robert Zivadinov - Istvan Pirko


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