Advances in understanding gray matter pathology in multiple sclerosis: Are we ready to redefine disease pathogenesis?

Robert Zivadinov, Istvan Pirko

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

The purpose of this special issue in BMC Neurology is to summarize advances in our understanding of the pathological, immunological, imaging and clinical concepts of gray matter (GM) pathology in patients with multiple sclerosis (MS). Review articles by Lucchinetti and Popescu, Walker and colleagues, Hulst and colleagues and Horakova and colleagues summarize important recent advances in understanding GM damage and its implications to MS pathogenesis. They also raise a number of important new questions and outline comprehensive approaches to addressing those questions in years to come. In the last decade, the use of immunohistochemistry staining methods and more advanced imaging techniques to detect GM lesions, like double inversion recovery, contributed to a surge of studies related to cortical and subcortical GM pathology in MS. It is becoming more apparent from recent biopsy studies that subpial cortical lesions in early MS are highly inflammatory. The mechanisms responsible for triggering meningeal inflammation in MS patients are not yet elucidated, and they should be further investigated in relation to their role in initiating and perpetuating the disease process. Determining the role of antigens, environmental and genetic factors in the pathogenesis of GM involvement in MS is critical. The early involvement of cortical and subcortical GM damage in MS is very intriguing and needs to be further studied. As established in numerous cross-sectional and longitudinal studies, GM damage is a better predictor of physical disability and cognitive impairment than WM damage. Monitoring the evolution of GM damage is becoming an important marker in predicting future disease course and response to therapy in MS patients.

Original languageEnglish (US)
Article number9
JournalBMC Neurology
Volume12
DOIs
StatePublished - Mar 6 2012

Fingerprint

Multiple Sclerosis
Pathology
Gray Matter
Neurology
Longitudinal Studies
Cross-Sectional Studies
Immunohistochemistry
Staining and Labeling
Inflammation
Biopsy
Antigens

Keywords

  • Atrophy
  • Clinical
  • Cortical
  • Double inversion recovery
  • Gray matter
  • Meningeal inflammation
  • Mri
  • Multiple sclerosis
  • Pathology
  • Subcortical
  • Treatment

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Advances in understanding gray matter pathology in multiple sclerosis : Are we ready to redefine disease pathogenesis? / Zivadinov, Robert; Pirko, Istvan.

In: BMC Neurology, Vol. 12, 9, 06.03.2012.

Research output: Contribution to journalArticle

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