title: MR imaging quantitation of gray matter involvement in multiple sclerosis and its correlation with disability measures and neurocognitive testing.
abstract: OBJECTIVE
  Multiple sclerosis (MS) is the most common inflammatory disease of the central nervous system and manifests both physical and neurocognitive disabilities. Although predominantly a disease of the white matter, MS is also characterized by lesions in the gray matter. Previous pathologic studies have found that cortical and deep gray matter lesions comprised 5% and 4%, respectively, of total lesions. Using software for lesion detection and quantitation, our study was designed to determine MS involvement in the cortical and deep gray matter and to correlate gray matter lesion load with neurocognitive function and the Kurtzke Expanded Disability Status Scale.
  
  
  METHODS
  Using a semiautomated segmentation algorithm that detected and delineated all possible brain MS lesions on MR images, we investigated gray matter lesion volume in 18 patients with untreated relapsing-remitting MS. Cortical and deep gray matter lesions then were correlated with the neurocognitive and physical disability measurements.
  
  
  RESULTS
  We found that cortical gray matter lesions comprised approximately 5.7% of the total lesion volume, whereas deep gray matter lesions comprised another 4.6% in this patient cohort. No strong correlations were found between gray matter lesions and disability status or neurocognitive function.
  
  
  CONCLUSIONS
  These results are similar to those found in previous pathologic studies. The cortical lesion load in cases of relapsing-remitting MS, as measured by MR imaging, represents less than 6% of the total lesion volume and does not correlate with disability measures or neurocognitive tests.
authors.affiliation: Department of Radiology, University of Pennsylvania Medical Center, Philadelphia 19104, USA.
authors.forename: I
authors.initials: I
authors.lastname: Catalaa
authors.forename: J C
authors.initials: JC
authors.lastname: Fulton
authors.forename: X
authors.initials: X
authors.lastname: Zhang
authors.forename: J K
authors.initials: JK
authors.lastname: Udupa
authors.forename: D
authors.initials: D
authors.lastname: Kolson
authors.forename: M
authors.initials: M
authors.lastname: Grossman
authors.forename: L
authors.initials: L
authors.lastname: Wei
authors.forename: J C
authors.initials: JC
authors.lastname: McGowan
authors.forename: M
authors.initials: M
authors.lastname: Polansky
authors.forename: R I
authors.initials: RI
authors.lastname: Grossman
mesh_terms: D000328:Adult; D002540:Cerebral Cortex / Q000473:pathology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000175:diagnosis*; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests