“…Across the disease span, if left untreated, the white matter atrophy rate remains rather stable at 3-fold normal, but GM atrophy rate dramatically increases from 3.4fold normal in CIS to 14-fold normal in SPMS (17). This localized GM atrophy has recently been found to be regionally selective, mainly involving deep structures, such as the thalamus, putamen, and caudate, and cortical regions, such as the sensorimotor cortex, insula, superior temporal, and cingulate gyrus, while these regions were functionally connected (34). In a 5-years followup study, it was shown that structural damage and especially cortical atrophy may predict cognitive decline in PwMS (35).…”