Several neuropathologic and imaging studies have consistently confirmed that multiple sclerosis affects both white (WM) and gray matter (GM) and that GM damage plays a key role in disability progression. However, differently from WM damage, the less inflammatory cell infiltration, the absence of significant blood-brain barrier damage, the low myelin density in upper cortical layers, as well as technical constraints, make the GM damage almost undetectable by means of conventional MR imaging.
Keywords: Cortical lesions; Gray matter damage; MR imaging; Multiple sclerosis; Normal-appearing gray matter.
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