MR imaging of gray matter involvement in multiple sclerosis: implications for understanding disease pathophysiology and monitoring treatment efficacy.

Recent pathologic and MR imaging studies have challenged the classic view of MS as a chronic inflammatory-demyelinating condition affecting solely the WM of the central nervous system. Indeed, an involvement of the GM has been shown to occur from the early stages of the disease, to progress with time, and to be only moderately correlated with the extent of WM injury. In this review, we summarize how advances in MR imaging technology and methods of analysis are contributing to ameliorating the detection of focal lesions and to quantifying the extent of "occult" pathology and atrophy, as well as to defining the topographic distribution of such changes in the GM of patients with MS.

Sensorimotor network rewiring in mild cognitive impairment and Alzheimer's disease.

This study aimed at elucidating whether (a) brain areas associated with motor function show a change in functional magnetic resonance imaging (fMRI) signal in amnestic mild cognitive impairment (aMCI) and Alzheimer's disease (AD), (b) such change is linear over the course of the disease, and (c) fMRI changes in aMCI and AD are driven by hippocampal atrophy, or, conversely, reflect a nonspecific neuronal network rewiring generically associated to brain tissue damage. FMRI during the performance of a simple motor task with the dominant right-hand, and structural MRI (i.e.

Primary progressive multiple sclerosis: tactile-associated functional MR activity in the cervical spinal cord.

Purpose: To assess the extent of tactile-associated cervical spinal cord activation in patients with primary progressive (PP) multiple sclerosis (MS) and to investigate the relationship between spinal cord functional activation and the severity of cervical spinal cord and brain structural damage by using magnetic resonance (MR) images.

Materials And Methods: The study was conducted with institutional review board approval. Written informed consent was obtained from each participant.

Evidence of thalamic gray matter loss in pediatric multiple sclerosis.

Objective: We used voxel-based morphometry (VBM) to assess the pattern of regional gray matter (GM) loss in patients with pediatric multiple sclerosis (MS) and its relation with the Expanded Disability Status Scale (EDSS) score, disease duration, and the extent of T2 lesion load (LL).

Methods: From 28 patients with pediatric relapsing-remitting MS (16 girls; mean age = 14.4 years, range = 7 to 16 years) and 21 matched controls, dual-echo and three-dimensional T1-weighted magnetization prepared rapid acquisition gradient echo sequences were acquired.

Magnetization transfer magnetic resonance imaging of the brain, spinal cord, and optic nerve.

Magnetic resonance imaging is highly sensitive in revealing CNS abnormalities associated with several neurological conditions, but lacks specificity for their pathological substrates. In addition, MRI does not allow evaluation of the presence and extent of damage in regions that appear normal on conventional MRI sequences and that postmortem studies have shown to be affected by pathology. Quantitative MR-based techniques with increased pathological specificity to the heterogeneous substrates of CNS pathology have the potential to overcome such limitations.

Defining the response to multiple sclerosis treatment: the role of conventional magnetic resonance imaging.

During the last two decades, conventional MRI (cMRI) has been extensively used in the diagnostic workup of multiple sclerosis (MS) patients, to monitor the natural history of the disease and to evaluate the efficacy of experimental treatments in randomised, controlled clinical trials. In the latter context, a major issue is represented by the high intra- and inter-individual heterogeneity of the MS patterns of disease activity and evolution. Such heterogeneity might explain, at least partially, the weak correlations found between clinical and cMRI aspects in patients with established MS, which is particularly evident when individual patients are considered.

MR imaging of Devic's neuromyelitis optica.

Devic's neuromyelitis optica (NMO) is a neurological condition characterized by a severe involvement of the optic nerves and spinal cord in a mono- or multi-phasic manner. Recent pathologic, cerebrospinal fluid and conventional magnetic resonance imaging (MRI) studies have shown abnormalities which might help in differentiating patients with NMO from those with multiple sclerosis. This review article summarizes the main results obtained using conventional MRI in NMO, which has contributed to the definition of internationally-accepted diagnostic criteria, and those obtained from the application of modem quantitative MR techniques which are significantly changing our views on NMO pathobiology.

Diffusion tensor and magnetization transfer MR imaging of early-onset multiple sclerosis.

Multiple sclerosis (MS) is a chronic, demyelinating disease of the central nervous system (CNS) with the onset of symptoms typically occurring between the age of 20 and 40 years. However, in about 3% to 12% of the cases, the onset of the disease is before 16 years of age. This review summarizes the main results obtained by the application of conventional and non-conventional MRI techniques to the assessment of patients with early-onset MS, which showed that the overall amount of CNS damage in these subjects is mild, compared to that typically detected in the adult-form of the disease.

A preliminary diffusion tensor and magnetization transfer magnetic resonance imaging study of early-onset multiple sclerosis.

Background: Early-onset multiple sclerosis (MS) typically has a more favorable course than adult-onset disease.

Objective: To assess the extent of microscopic tissue damage in the brain and cervical cord of patients with early-onset MS.

Design: During a single magnetic resonance imaging session, images of the brain and spinal cord were obtained using diffusion tensor and magnetization transfer magnetic resonance imaging.

MRI aspects of the "inflammatory phase" of multiple sclerosis.

In early relapsing-remitting (RR) multiple sclerosis (MS), conventional magnetic resonance imaging (MRI) has proved to be a valuable tool to assess disease activity over time. However, conventional MRI can only provide gross estimates of irreversible tissue damage within and outside such lesions. Other MR-based techniques, including magnetization transfer MRI, diffusion-weighted MRI, proton MR spectroscopy and functional MRI, have the potential to provide additional pieces of information about the nature and the extent of MS tissue damage since the early "inflammatory phase" of the disease.

Disturbed function and plasticity in multiple sclerosis as gleaned from functional magnetic resonance imaging.

Purpose Of Review: This review is intended to provide an up-to-date summary of the main functional magnetic resonance imaging studies conducted in patients with multiple sclerosis, and to show how such studies are changing our views on the ability of the multiple sclerosis brain to limit the clinical consequences of irreversible structural tissue damage.

Recent Findings: Brain cortical reorganization is a common phenomenon occurring in patients with multiple sclerosis, independent of disease duration and clinical phenotype, which can be elicited by macroscopic lesions, as well as by the presence of 'occult' multiple sclerosis-related damage of the brain and cervical cord. An increased recruitment of the cerebral networks involved in the performance of given tasks might represent a first step in cortical reorganization with the potential to maintain a normal level of function in the course of multiple sclerosis.