The changing clinical course of multiple sclerosis: A matter of gray matter

Calabrese, Massimiliano; Romualdi, Chiara; Poretto, Valentina; Favaretto, Alice; Morra, Aldo; Rinaldi, Francesca; Perini, Paola; Gallo, Paolo

doi:10.1002/ana.23882

Cited by 78 publications

(86 citation statements)

References 29 publications

(44 reference statements)

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“…Interestingly, the subpopulation of SPMS cases with higher levels of meningeal inflammation and grey matter damage were characterised clinically by a more rapidly progressive disease course 17,37,94,105 , although it should be noted that this population of patients clearly represent the more aggressive end of the spectrum of heterogeneous presentations. The link between cortical pathology and a rapidly progressive disease course has also been described in a large proportion of multiple sclerosis cases using non-conventional imaging techniques 39,105 .…”

Section: Role Of Meningeal Inflammatory Infiltratesmentioning

confidence: 99%

“…The link between cortical pathology and a rapidly progressive disease course has also been described in a large proportion of multiple sclerosis cases using non-conventional imaging techniques 39,105 . These results support the idea that increased grey matter pathology, alone or in addition to white matter pathology, may be associated with a more rapid and aggressive disease course from early phases of the disease and that meningeal inflammation may in part be responsible for this increased pathology.…”

Section: Role Of Meningeal Inflammatory Infiltratesmentioning

confidence: 99%

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Exploring the origins of grey matter damage in multiple sclerosis

et al. 2015

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Multiple sclerosis is characterized at the gross pathological level by the presence of widespread focal demyelinating lesions of the myelin-rich white matter. However, it is becoming clear that grey matter is not spared, even during the earliest phases of the disease. Furthermore, grey matter damage may have an important role both in physical and cognitive disability. Grey matter pathology involves both inflammatory and neurodegenerative mechanisms, but the relationship between the two is unclear. Histological, immunological and neuroimaging studies have provided new insight in this rapidly expanding field, and form the basis of the most recent hypotheses on the pathogenesis of grey matter damage. DOI: https://doi.org/10.1038/nrn3900Posted at the Zurich Open Repository and Archive, University of Zurich ZORA URL: https://doi.org/10.5167/uzh-111099 Accepted Version Originally published at: Calabrese, Massimiliano; Magliozzi, Roberta; Ciccarelli, Olga; Geurts, Jeroen J G; Reynolds, Richard; Martin, Roland (2015). Exploring the origins of grey matter damage in multiple sclerosis. Nature Reviews Neuroscience, 16 (3) AbstractMultiple sclerosis is characterised at the gross pathological level by the presence of widespread focal demyelinating lesions of the myelin-rich white matter. However, in recent years it has become clear that grey matter is not spared, even during the earliest phases of the disease. Furthermore, grey matter damage has been suggested to have an important role both in physical and cognitive disability. Grey matter pathology involves both inflammatory and neurodegenerative mechanisms, but the relationship between the two is unclear. This review will summarize and highlight important histological, immunological, and neuroimaging results from this rapidly expanding field and will address the most recent hypotheses on the pathogenesis of grey matter damage.

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Section: Role Of Meningeal Inflammatory Infiltratesmentioning

confidence: 99%

Section: Role Of Meningeal Inflammatory Infiltratesmentioning

confidence: 99%

Exploring the origins of grey matter damage in multiple sclerosis

et al. 2015

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“…These associations become more remarkable with disease progression from CIS to SPMS. [54][55][56][57][58][59][60][61][62][63]. Particularly worth of interest are studies that have demonstrated an association between cerebellar GM loss and the degree of disability in the cerebellar functional system of EDSS [60,64].…”

Section: Gm Atrophy and Disabilitymentioning

confidence: 99%

Effects of disease modifying therapies on brain and grey matter atrophy in relapsing remitting multiple sclerosis

Favaretto

Lazzarotto

Margoni

et al. 2018

Mult Scler Demyelinating Disord

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Background: Progressive brain atrophy is a major feature of multiple sclerosis (MS) pathology and is actually considered a major determinant of the progressive accumulation of physical and cognitive disability in MS patients. Although brain atrophy may have different pathological substrates, several lines of evidence suggest that in disease modifying drug (DMD)-treated MS patients, the higher is the anti-inflammatory effect of the DMD the lower is the progression of brain volume loss, grey matter atrophy and the accumulation of disability. Areas covered: Magnetic resonance imaging (MRI)-based measurements of inflammation (focal white matter and grey matter lesions) and neurodegeneration (decrease in brain volume, cortical and deep grey matter atrophy) are currently included among the primary or secondary end-points of Phase II and III randomized clinical trials (RCT). This review summarizes literature data on the effects of DMDs on either whole brain or grey matter atrophy emerged from RCT and from post-marketing studies.

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“…[1][2][3] In some individuals, cortical demyelination exceeds white matter demyelination, 2 and cortical lesions may be more strongly associated with disability and disability progression than white matter lesions. [4][5][6][7][8] Cortical and white matter lesions have potentially distinct origins and levels of inflammation, 3,[9][10][11][12][13] suggesting that they may have different clinical significance and response to treatment. Finally, the clinical course of MS is often not fully explained by volume and accumulation of white matter lesions, 14 making better understanding of other types of MS pathology, including cortical lesions, imperative.…”

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confidence: 99%

Improved Visualization of Cortical Lesions in Multiple Sclerosis Using 7T MP2RAGE

Beck

Sati

Sethi

et al. 2018

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Cortical lesions are common and often extensive in multiple sclerosis but are difficult to visualize by MRI, leaving important questions about their clinical implications and response to therapy unanswered. Our aim was to determine whether cortical lesions are better visualized using magnetization prepared 2 rapid acquisition gradient echoes (MP2RAGE) than T2*-weighted imaging on 7T MR imaging.

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The changing clinical course of multiple sclerosis: A matter of gray matter

Cited by 78 publications

References 29 publications

Exploring the origins of grey matter damage in multiple sclerosis

Exploring the origins of grey matter damage in multiple sclerosis

Effects of disease modifying therapies on brain and grey matter atrophy in relapsing remitting multiple sclerosis

Improved Visualization of Cortical Lesions in Multiple Sclerosis Using 7T MP2RAGE

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