title: Grey matter lesions in MS: from histology to clinical implications.
abstract: Although multiple sclerosis (MS) is a chronic inflammatory-demyelinating disease of the white matter (WM) of the central nervous system, several pathological and magnetic resonance imaging (MRI) studies have shown that a large amount of lesions are located in the cortical and deep gray matter. The histopathological and immunological characteristics of cortical lesions differ significantly from those located in the WM, which suggests a location-dependent expression of the MS immunopathological process. More recently, the availability of not-conventional MRI sequences having higher sensitivity for the gray matter has allowed to depict in vivo a portion of such lesions. The available MRI data obtained on large cohorts of patients, having different clinical forms of the disease, indicate that cortical lesions can be detected early in the disease course, sometimes even before the appearance of WM lesions, and correlate with the severity of physical disability and cognitive impairment, and with the evolution of the disease toward the secondary progressive phase. This review provides a summary of the main histopathological and MRI findings of cortical lesions in MS and discusses their possible clinical implications.
authors.affiliation: The Multiple Sclerosis Center, Deptartment of Neurosciences, University Hospital of Padova, Padua, Italy. calabresem@hotmail.it
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Calabrese
authors.forename: Alice
authors.initials: A
authors.lastname: Favaretto
authors.forename: Valeria
authors.initials: V
authors.lastname: Martini
authors.forename: Paolo
authors.initials: P
authors.lastname: Gallo
mesh_terms: D000818:Animals; D002540:Cerebral Cortex / Q000473:pathology*; D003072:Cognition Disorders / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009103:Multiple Sclerosis / Q000150:complications / Q000473:pathology*
keywords: Multiple Sclerosis; cognitive dysfunction; cortical lesions; physical disability