Cervical cord and brain grey matter atrophy independently associate with long-term MS disability

Current Concepts in Multiple Sclerosis: Autoimmunity Versus Oligodendrogliopathy

“…Despite its sensitivity, however, the T2WI-high lesion load either in the brain or spinal cord only weakly correlates with EDSS [45,46]. In contrast, there is increasing evidence that the degree of gray matter pathology (i.e., demyelinating cortical lesions occasionally with axonal damage and neuronal loss) best correlates with the disability in MS [46][47][48][49]. The introduction of a novel sequence, the double inversion recovery sequence, enabled cortical lesions to be detected with 1.5 Tesla MRI, and such lesions are reported to be observed very early even in RRMS [50,51].…”

Effect of disease-modifying therapies on brain volume in relapsing–remitting multiple sclerosis: Results of a five-year brain MRI study

“…The pathologic substrate of brain atrophy in MS is complex but broadly comprised of diffuse demyelination and axonal loss that occurs both in T2 lesions as well as the so-called normal appearing brain tissue [2,3]. Several longitudinal studies have established the utility of studying brain atrophy in MS, which arguably remains one of the best prognostic tools to predict disability in MS [4][5][6]. There is no clear distinction in the MS literature between the terms "brain atrophy" and "brain volume loss".…”

Multicenter Validation of Mean Upper Cervical Cord Area Measurements from Head 3D T1-Weighted MR Imaging in Patients with Multiple Sclerosis

“…[2][3][4] Furthermore, a modest or strong correlation between spinal cord atrophy and disability has been demonstrated in numerous studies, suggesting that spinal cord atrophy is an essential determinant of clinical disability and a potential outcome measure to monitor MS disease progression. [5][6][7] The measurement of the upper cervical cord area is a well-established method for the assessment of spinal cord atrophy and has been applied in most studies so far. 2,3,5,8,9 Both image acquisition and spinal cord segmentation are technically feasible and more accurate in the upper cervical region compared with other parts of the cord or the entire cord.…”