Medscape: Gray Matter Imaging Reveals MS Changes Missed on Standard MRI 2019

by Nancy Melville

June 3, 2019 // SEATTLE — Automated three-dimensional (3D) MRI volumetric measurement of gray matter structures in the brain in patients with primary progressive multiple sclerosis (PPMS) reveals significant volume loss and other abnormalities that typically would not be detected on standard MRI of white matter for patients with MS, offering potentially essential insights for clinical decision making, a new study suggests.

Although use of conventional MRI for patients with MS focuses largely on lesions found in the white matter of the brain, the technology is less sensitive to gray matter structures, owing to the lower contrast of these structures.

Important changes in gray matter structures, including the hippocampus, the amygdala, and the thalamus, are known to occur in patients with PPMS, particularly in relation to cognitive decline. Such changes often go undetected.

"One of the major limitations of a standard MRI is that one doesn't see the lesions or the changes that take place in gray matter until very late in the disease," lead author Ted Rothstein, MD, of the Department of Neurology, George Washington University, Washington, DC, told Medscape Medical News.