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Multiple Sclerosis International
Volume 2013 (2013), Article ID 627870, 16 pages
http://dx.doi.org/10.1155/2013/627870
Review Article

Gray Matter Pathology in MS: Neuroimaging and Clinical Correlations

Radiology Department, Division of Neuroradiology, University of Colorado Denver, 12700 E 19th Avenue Mail Stop C278, Aurora, CO 80045, USA

Received 8 April 2013; Accepted 28 May 2013

Academic Editor: Augusto A. Miravalle

Copyright © 2013 Justin Morris Honce. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

It is abundantly clear that there is extensive gray matter pathology occurring in multiple sclerosis. While attention to gray matter pathology was initially limited to studies of autopsy specimens and biopsies, the development of new MRI techniques has allowed assessment of gray matter pathology in vivo. Current MRI techniques allow the direct visualization of gray matter demyelinating lesions, the quantification of diffuse damage to normal appearing gray matter, and the direct measurement of gray matter atrophy. Gray matter demyelination (both focal and diffuse) and gray matter atrophy are found in the very earliest stages of multiple sclerosis and are progressive over time. Accumulation of gray matter damage has substantial impact on the lives of multiple sclerosis patients; a growing body of the literature demonstrates correlations between gray matter pathology and various measures of both clinical disability and cognitive impairment. The effect of disease modifying therapies on the rate accumulation of gray matter pathology in MS has been investigated. This review focuses on the neuroimaging of gray matter pathology in MS, the effect of the accumulation of gray matter pathology on clinical and cognitive disability, and the effect of disease-modifying agents on various measures of gray matter damage.