Cortical lesions and brain atrophy in MS
Journal of the Neurological SciencesPublished 1 June 2005
Alexandra Kutzelnigg, Hans Lassmann
Citations133
SJR quartileQ1
SJR score1.15
SNIP0.99
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The possibility that disease involvement of grey matter structures may significantly contribute to clinical disability in multiple sclerosis patients is discussed.
Abstract
Multiple sclerosis is generally considered a disease of the white matter. However, this is only one pathological aspect of the disease as demyelination is prominent in the grey matter of deep cerebral nuclei and the cerebral cortex. In this review, we discuss the possibility that disease involvement of grey matter structures may significantly contribute to clinical disability in multiple sclerosis patients.
Keywords
MedicineNeuroscienceBiochemistry, Genetics and Molecular Biology
New England Journal of MedicineAxonal Transection in the Lesions of Multiple Sclerosis
4,024 Citations1998Bruce D. Trapp, John W. Peterson +4 more
Transected axons are common in the lesions of multiple sclerosis, and axonal transection may be the pathologic correlate of the irreversible neurologic impairment in this disease.
NeurologyCognitive dysfunction in multiple sclerosis.
2,109 Citations1991Stephen M. Rao, Gary J. Leo +2 more
Cognitive impairment in multiple sclerosis patients was not significantly associated with illness duration, depression, disease course, or medication usage, but was significantly (albeit weakly) correlated with physical disability.
BrainTHE NATURAL HISTORY OF MULTIPLE SCLEROSIS: A GEOGRAPHICALLY BASED STUDY
1,452 Citations1989Brian G. Weinshenker, B. Bass +5 more
The outcome of multiple sclerosis, assessed according to the Kurtzke Disability Status Scale, was reviewed in 1,099 consecutive patients followed in London, Canada, between 1972 and 1984 and the rate at which disability develops after the onset of a progressive phase of MS is presented.
Annals of NeurologyTransected neurites, apoptotic neurons, and reduced inflammation in cortical multiple sclerosis lesions
1,402 Citations2001John W. Peterson, Lars Eirik Bø +3 more
The hypothesis that demyelination, axonal transection, dendritic tran section, and apoptotic loss of neurons in the cerebral cortex contribute to neurological dysfunction in MS patients is supported.
New England Journal of MedicineRelapses and Progression of Disability in Multiple Sclerosis
1,310 Citations2000Christian Confavreux, Sandra Vukusic +2 more
The time course of progressive, irreversible disease among patients with the primary progressive type of multiple sclerosis was not affected by the presence or absence of superimposed relapses.
BrainThe natural history of multiple sclerosis:a geographically based study
1,173 Citations1999David A. Cottrell, Marcelo Kremenchutzky +5 more
From clinical onset, rate of progression was faster in the PP- multiple sclerosis group than in the secondary progressive (SP)-multiple sclerosis group, and when the rates of progression from onset of the progressive phase to DSS 6, 8 and 10 were compared, SP-multiple sclerosis had a more rapid progressive phase.
NeurologyCognitive dysfunction in multiple sclerosis.
897 Citations1991Stephen M. Rao, Gary J. Leo +4 more
It is suggested that cognitive dysfunction is a major factor in determining the quality of life of patients with MS.
BrainAcute axonal injury in multiple sclerosis: Correlation with demyelination and inflammation
892 Citations2000Andreas Bitsch
Characterizing the association of axonal injury and histopathological hallmarks of multiple sclerosis such as demyelination, cellular infiltration and expression of inflammatory mediators and quantifying axonal reduction and signs of acute axonal damage in early lesion development of chronic multiple sclerosis found it to be independent of demYelinating activity and inflammation.
New England Journal of MedicineA Longitudinal Study of Abnormalities on MRI and Disability from Multiple Sclerosis
863 Citations2002Peter Brex, Olga Ciccarelli +4 more
In patients who first present with isolated syndromes suggestive of multiple sclerosis, the increases in the volume of the lesions seen on magnetic resonance imaging of the brain in the first five years correlate with the degree of long-term disability from multiple sclerosis.
NeurologyDisease modifying therapies in multiple sclerosis: Subcommittee of the American Academy of Neurology and the MS Council for Clinical Practice Guidelines [RETIRED]
798 Citations2002Douglas S. Goodin, Elliot M. Frohman +8 more
Four different clinical courses of MS have been defined and the first, relapsing–remitting MS (RRMS), is characterized by self-limited attacks of neurologic dysfunction, but at some point the attack rate is reduced and the course becomes characterized by a steady deterioration in function unrelated to acute attacks.
BrainCortical lesions in multiple sclerosis
766 Citations1999Desmond P. Kidd, Frederik Barkhof +4 more
Investigation of the cortical venous supply shows how such lesions may arise, and why the majority also involve the underlying white matter.
Journal of Neuropathology & Experimental NeurologySubpial Demyelination in the Cerebral Cortex of Multiple Sclerosis Patients
749 Citations2003Lars Bø, Christian A. Vedeler +3 more
The results indicate that the cerebral cortex is likely to be a predilection site for MS lesions and identify general cortical subpial demyelination as a distinct pattern occurring in a significant subpopulation of MS patients.
Current Opinion in NeurologyThe clinico-radiological paradox in multiple sclerosis revisited
700 Citations2002Frederik Barkhof
It is concluded that much progression has been made in magnetic resonance techniques so that the clinico‐radiological dissociation has indeed proved to be a paradox, and corroborates with conventional wisdom that one should not rely on a single magnetic resonance measure, but take full advantage of the fact that magnetic resonance is able to provide multidimensional information.
Journal of Neurology Neurosurgery & PsychiatryThe distribution of plaques in the cerebrum in multiple sclerosis
540 Citations1962Betty Brownell, John T. Hughes
The present study was undertaken to determine with some precision the position and relative frequency of plaques seen macroscopically in the cerebral hemispheres in a series of necropsied cases of multiple sclerosis.
Annals of NeurologyMajor differences in the dynamics of primary and secondary progressive multiple sclerosis
491 Citations1991Alan J. Thompson, Allan G. Kermode +5 more
Findings may indicate a difference in the dynamics of disease activity between the two forms of progressive MS, particularly in relation to the inflammatory component of the lesions, and have important implications for the selection of patients and the monitoring of diseaseactivity in therapeutic trials.
NeurologyEvidence of early cortical atrophy in MS
485 Citations2003Nicola De Stefano, Paul M. Matthews +10 more
The extent of the changes suggests that neocortical GM pathology may occur early in the course of the disease in both RR and PP MS patients and contribute significantly to neurologic impairment.
Multiple Sclerosis JournalIntracortical multiple sclerosis lesions are not associated with increased lymphocyte infiltration
475 Citations2003Lars Bø, Christian A. Vedeler +3 more
The data indicate that areas of intracortical demyelination in chronic MS are not associated with an increased number of lymphocytes, or an altered distribution of lymphocyte subsets, when compared with control areas in MS and control patients.
BrainBrain atrophy in clinically early relapsing–remitting multiple sclerosis
459 Citations2002Declan Chard, Colette Griffin +4 more
The results indicate that significant brain atrophy, affecting both grey and white matter, occurs early in the clinical course of multiple sclerosis.
Annals of NeurologyImmunopathology of secondary‐progressive multiple sclerosis
456 Citations2001John W. Prineas, Eunice E. Kwon +6 more
Findings suggest that slowly expanding lesions (progressive plaques), in which ongoing myelin breakdown occurs in the absence of florid perivascular cell cuffing or other histological signs of acute inflammation, contribute to disease progression in cases of secondary‐progressive multiple sclerosis.
PubMedDiagnostic criteria for primary progressive multiple sclerosis: a position paper.
353 Citations2000Alan J. Thompson, Xavier Montalbán +7 more
NeurologyA longitudinal study of brain atrophy in relapsing multiple sclerosis
338 Citations1999Jack H. Simon, L. Jacobs +16 more
In patients with relapsing MS and only mild to moderate disability, significant cerebral atrophy is already developing that can be measured over periods of only 1 to 2 years.
BrainCognitive function and fMRI in patients with multiple sclerosis: evidence for compensatory cortical activation during an attention task
338 Citations2002Wolfgang Staffen, Ally Pax Arcari Mair +8 more
The different patterns of activation, accompanied with intact performance in a sustained attention task of the multiple sclerosis sample compared with healthy controls, are interpreted as the consequence of compensatory mechanisms.
PubMedThe neuropathology of multiple sclerosis.
327 Citations2000Ludwin Sk
The pathology of multiple sclerosis is reviewed in an attempt to allow the reader to better understand the pathogenesis of the lesions.
BrainEvidence for adaptive functional changes in the cerebral cortex with axonal injury from multiple sclerosis
311 Citations2000Hasini Reddy, Sridar Narayanan +5 more
Results suggest that compensatory cortical adaptive responses may help to account for the limited relationship between conventional MRI measures of lesion burden and clinical measures of disability, and that therapies directed towards promoting cortical reorganization in response to brain injury could enhance recovery from relapses of multiple sclerosis.
Annals of NeurologyDiagnostic criteria for primary progressive multiple sclerosis: A position paper
306 Citations2000Alan J. Thompson, Xavier Montalbán +7 more
New diagnostic criteria developed by a group of investigators on the basis of a review of their considerable experience with primary progressive multiple sclerosis require prospective validation in a cohort of newly diagnosed patients and by postmortem examination.
Journal of Neurology Neurosurgery & PsychiatryMagnetisation transfer ratio and mean diffusivity of normal appearing white and grey matter from patients with multiple sclerosis
290 Citations2001Mara Cercignani
A technique was developed for segmenting white and grey matter with the potential for improving the understanding of the pathophysiology of many neurological conditions and its application to the study of multiple sclerosis confirms the presence of a diffuse tissue damage in the NAWM of these patients and suggests that subtle changes also occur in the NAGM.
Annals of NeurologyThe motor cortex shows adaptive functional changes to brain injury from multiple sclerosis
273 Citations2000M Lee, Hasini Reddy +6 more
It is demonstrated that cortical recruitment for simple finger movements can change both quantitatively and qualitatively in the SMCs of MS patients, suggesting that cortical reorganization or “unmasking” of latent pathways can contribute to functional recovery.
Transactions of the Royal Society of EdinburghXVIII.–The Histology of Disseminated Sclerosis
273 Citations1916James Dawson
The research of which this paper gives an account was originated by the late Dr Alexander Bruce and undertaken in conjunction with him and most of the material used had been accumulated by him during the later years of his life.
American Journal Of PathologyTransection of Major Histocompatibility Complex Class I-Induced Neurites by Cytotoxic T Lymphocytes
266 Citations2001Isabelle M. Medana, Marianne M. Martinic +2 more
Major histocompatibility complex class I/peptide-restricted CD8(+) T lymphocytes can induce lesions to neurites, which might be responsible for axonal damage during neuroinflammatory diseases.
NeurologyInterferon β-1a in primary progressive MS
248 Citations2003Siobhan M Leary, D. H. Miller +4 more
This study has demonstrated that interferon β-1a 30 μg was well tolerated, identified useful outcome measures, but showed no efficacy on the primary outcome measure or on most of the secondary outcome measures.
BrainThe progress of cognitive decline in multiple sclerosis. A controlled 3- year follow-up
230 Citations1997Päivi Kujala
The study demonstrated that intact cognitive functioning in multiple sclerosis may remain stable, whereas incipient cognitive decline seems to be widespread and progressive in nature.
Annals of NeurologyAdaptive functional changes in the cerebral cortex of patients with nondisabling multiple sclerosis correlate with the extent of brain structural damage
227 Citations2002Maria A. Rocca, Andrea Falini +4 more
This study shows that cortical activation occurs over a rather distributed sensorimotor network in nondisabled relapsing‐remitting multiple sclerosis patients, and suggests that increased recruitment of this cortical network contributes to the limitation of the functional impact of white matter multiple sclerosis injury.
Archives of NeurologyAssessment of Normal-Appearing White and Gray Matter in Patients With Primary Progressive Multiple Sclerosis
222 Citations2002Marco Rovaris, Marco Bozzali +11 more
This study confirms that, in patients with PPMS, normal-appearing white and gray matter are not spared by disease-related pathological processes, although they are affected to a lesser degree than in Patients with SPMS.
Archives of NeurologyFluid-Attenuated Inversion Recovery Magnetic Resonance Imaging Detects Cortical and Juxtacortical Multiple Sclerosis Lesions
211 Citations2001Rohit Bakshi, Suzie Ariyaratana +2 more
FLAIR can detect many cortical and juxtacortical lesions in MS, which were appreciated previously in autopsy studies but usually missed by magnetic resonance imaging during life.
The NeuroscientistNeurodegeneration in Multiple Sclerosis: Relationship to Neurological Disability
197 Citations1999Bruce D. Trapp, Richard M. Ransohoff +2 more
This view of MS provides a concep tional framework that explains conversion of RR-MS to SP-MS and provides a rationale for early aggressive anti-inflammatory and neuroprotective therapies.
Brain PathologyAxonal Pathology in Multiple Sclerosis. A Historical Note
194 Citations1999Barbara Kornek, Hans Lassmann
BrainTHE NATURAL HISTORY OF MULTIPLE SCLEROSIS: A GEOGRAPHICALLY BASED STUDY
177 Citations1991Brian G. Weinshenker, George P. Rice +4 more
Overall the frequency of progression was lower and the staying times were longer at higher levels of disability, and the linearity of the DSS was lower, which has major implications for the design and conduct of clinical therapeutic trials in MS.
Journal of Neurology Neurosurgery & PsychiatryProgressive ventricular enlargement in patients with clinically isolated syndromes is associated with the early development of multiple sclerosis
160 Citations2002Catherine M. Dalton
Lesions and atrophy are both associated with early relapse leading to a diagnosis of clinical MS; this suggests that MR measures have a complementary role in monitoring the course of MS, even from the earliest clinical stage.
Journal of Neurology Neurosurgery & PsychiatryStudies on regional cerebral oxygen utilisation and cognitive function in multiple sclerosis.
147 Citations1984David J. Brooks, Klaus L. Leenders +4 more
Lowest levels of cerebral oxygen utilisation were found in patients with cerebral atrophy, and in patients in whom a significant fall in present full-scale IQ from estimated pre-morbid levels had occurred.
Journal of Neurology Neurosurgery & PsychiatrySpinal cord atrophy and disability in multiple sclerosis over four years: application of a reproducible automated technique in monitoring disease progression in a cohort of the interferon -1a (Rebif) treatment trial
135 Citations2003Xia Lin
Despite the small number of patients studied and the possible confounding effects of interferon treatment, this study showed that edge detection is reproducible and sensitive to changes in spinal cord area, and that this change is related to changes to clinical disability.
NeurologyOptimizing the association between disability and biological markers in MS
135 Citations2001Nynke F. Kalkers, Elisabeth Bergers +6 more
Although in the early phase of the disease the amount of focal demyelination is important, the residual brain volume seems to be more relevant in determining disability in later phases of the Disease.
BrainPrimary progressive multiple sclerosis: a 5-year clinical and MR study
129 Citations2003Gordon Ingle
Longer duration of follow-up demonstrates modest associations between change in clinical and MR measures and provides new insights into the pattern of change within and between individuals with PPMS.
Multiple Sclerosis JournalThe pathology of primary progressive multiple sclerosis
120 Citations2004Claudia F. Lucchinetti, Wolfgang Brück
This review will focus on the patho logical aspects of PPMS and pathogenic implications and a better understanding of the differences in PPMS pathology and patho genesis will lead to more effective treatment strategies.
Journal of Neurology Neurosurgery & PsychiatryOne year follow up study of primary and transitional progressive multiple sclerosis
115 Citations2000Valerie L. Stevenson
Although the monitoring of disease progression in this patient group is difficult, this study demonstrates changes in both lesion load and atrophy, which, if shown to correlate with clinical change over a longer time will facilitate therapeutic trial design.
Journal of the Neurological SciencesGray matter T2 hypointensity is related to plaques and atrophy in the brains of multiple sclerosis patients
107 Citations2001Rohit Bakshi, Jacek Dmochowski +2 more
It is concluded that gray matter hypointensity on T2WI may reflect pathologic iron deposition and brain degeneration in MS and is a useful surrogate outcome measure in therapeutic trials.
Archives of Neurology And PsychiatryTOPOGRAPHIC DISTRIBUTION OF PLAQUES IN THE SPINAL CORD IN MULTIPLE SCLEROSIS
107 Citations1950Torben Fog
The present work is an attempt to define the topographic distribution of plaques in the spinal cord in multiple sclerosis, thus contributing to the solution of the old and important question of the possible relation of vascular territories to the formation of plaque.
European NeurologyEpilepsy in Multiple Sclerosis
93 Citations2008Angelo Ghezzi, R Montanini +4 more
It is confirmed that multiple sclerosis is associated to a risk for epilepsy higher than that of the general population and frequency of seizures is associated with course of MS.
Journal of Neurology Neurosurgery & PsychiatrySeizures due to multiple sclerosis: seven patients with MRI correlations.
86 Citations1993Alan J. Thompson, Allan G. Kermode +3 more
MRI data of seven patients with clinically definite multiple sclerosis who developed epileptic seizures are presented and lesions implicated in the causation of seizures involved the cortex or subcortical area.
Journal of NeurologyLocalized 1 H magnetic resonance spectroscopy in mainly cortical gray matter of patients with multiple sclerosis
78 Citations2002Paola Sarchielli, O. Presciutti +6 more
The findings suggest that the pathological process in MS is not limited to either white matter lesions or normal-appearing white matter but extends into the cortical gray matter (occipito-parietal), particularly in the progressive form of the disease.
Journal of Neurology Neurosurgery & PsychiatryNATURAL HISTORY OF MULTIPLE SCLEROSIS
78 Citations2001George C. Ebers
Multiple Sclerosis JournalThe pathology of primary progressive multiple sclerosis
69 Citations2002Wolfgang Brück, Claudia F. Lucchinetti +1 more
The present review will focus on the current knowledge of the pathology of primary progressive multiple sclerosis lesions with respect to inflammation, oligodendrocyte/myelin pathology, axon destruction and immunopathology of the lesions.
The FASEB JournalPreservation of motor function by inhibition of CD8+ virus peptide‐specific T cells in Theiler's virus infection
67 Citations2001Aaron J. Johnson, Jadee L. Upshaw +3 more
These studies are the first to demonstrate a clear contribution of antiviral CD8+ T cells in neurological injury in a chronic‐progressive model of multiple sclerosis.
BrainOBSERVATIONS ON THE HISTOPATHOLOGY OF THE CEREBRAL LESIONS IN DISSEMINATED SCLEROSIS
65 Citations1936J. G. Greenfield, Lester S. King
Elsevier eBooksNeuropathology of Multiple Sclerosis
52 Citations2015Bogdan F. Gh. Popescu, Claudia F. Lucchinetti
This chapter will review the dynamic neuropathology of MS and discuss its clinical and pathogenic implications.
Journal of NeurologyZur Kasuistik der multiplen Herdsklerose des Gehirns und Rückenmarks
37 Citations1904Dinkler
Journal of NeurologyMonitoring disease activity and progression in primary progressive multiple sclerosis using MRI: sub-voxel registration to identify lesion changes and to detect cerebral atrophy
36 Citations2002Valerie L. Stevenson, Stephen M. Smith +3 more
Both of the new image analysis techniques appear to be promising as sensitive markers for disease progression in PPMS, with the correlation of total new T2 lesion volume with the progression of cerebral atrophy compared with a lack of correlation with the traditional net gain in T1 lesion load suggested.
The Natural History of Multiple Sclerosis
30 Citations2001Rajas Deshpande, Marcelo Kremenchutzky
Journal of the Neurological SciencesMultiple sclerosis: a white matter disease with associated gray matter damage
30 Citations2001Massimo Filippi
The increased perception of the limitations of conventional MRI in the in vivo assessment of MS pathology has led to the progressive application of non-conventional MR technology to quantify MS-related damage.
PubMedMagnetic resonance imaging in primary progressive multiple sclerosis.
11 Citations2002Gordon Ingle, Alan J. Thompson +1 more
Studies using newer MRI techniques, such as magnetization transfer imaging (MTI), diffusion-weighted imaging (DWI), magnetic resonance spectroscopy (MRS), and functional MRI (fMRI), are carried out, and their increased pathological specificity may be helpful in clarifying the underlying pathology of the condition.
