Therapeutic strategies for relapsing-remitting multiple sclerosis: a special focus on reduction of grey matter damage as measured by brain atrophy.
In the past two decades, several pathological and radiological findings convincingly demonstrated that damage of the cortical and deep grey matter is a key issue in multiple sclerosis with a significant impact on physical and cognitive disability. Moreover, it has become increasingly evident that the effect of available therapies on the inflammatory white matter damage is not a guarantee of a meaningful effect on the neurodegenerative process mainly affecting the grey matter. Despite the efficacy of all approved disease-modifying drugs should be measured considering such a relevant aspect of the disease, data from clinical trials are few, scattered and heterogeneous. The aim of this review is to summarize the evidence so far acquired on the effect of reducing grey matter damage produced by current and emerging disease-modifying therapies for multiple sclerosis.
Neurology section, Department of Neurological and Movement Sciences, Policlinico di Borgo Roma, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Piazzale Ludovico Antonio Scuro, 37134, Verona, Italy.
Massimiliano
M
Calabrese
Alberto
A
Gajofatto
Maria Donata
MD
Benedetti
D000818:Animals; D001284:Atrophy / Q000473:pathology / Q000601:surgery; D002986:Clinical Trials as Topic; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000175:diagnosis* / Q000473:pathology*; D016896:Treatment Outcome
disease-modifying treatment; grey matter damage; multiple sclerosis; neurodegeneration; neuroprotection