Grey Matter Fact:
Widespread
In Multiple Sclerosis,
Grey Matter pathology is widespread, progressive, and correlated with disability5-7
In Multiple Sclerosis,
Grey Matter pathology is widespread, progressive, and correlated with disability5-7
Recent advancements in imaging technology have revealed that Grey Matter pathology in multiple sclerosis (MS) is more important and prevalent than previously realized.1-4
Accumulating evidence from numerous longitudinal and imaging studies has shown that Grey Matter damage2-4:
Several cross-sectional studies have demonstrated that Grey Matter pathology is significantly correlated with both cognitive impairment and physical disability in MS patients.8
Among the negative outcomes associated with Grey Matter pathology are9:
View references on Grey Matter pathology.
—Roosendaal et al20
*In a cross-sectional study of 927 MS patients.
Physical Disability
In a 4-year longitudinal study (n=87), Grey Matter atrophy was correlated with sustained worsening of physical disability in MS patients.6
In a 2018 study of patients with multiple sclerosis (N=71), Grey Matter volume (cortical and deep grey) had the strongest association with the extent of walking disability.10
Recent findings from a 10-year follow-up study (n=152) suggest that confirmed disability progression (CDP) and Grey Matter atrophy may be inextricably linked.11
In a 2-year longitudinal study with more than 1200 patients with multiple sclerosis, researchers found that Deep Grey Matter volume loss was a dominant driver of disability accumulation across all MS phenotypes.12
Cognitive Disability
Data from several cross-sectional studies indicate that Grey Matter damage is significantly correlated with cognitive dysfunction, which can occur early in the course of disease.5,6,8,9,12-14
In a clinical trial with 67 patients with probable MS,
54%
Fatigue
In a retrospective MRI study of 1214 patients with MS,
Grey Matter volume loss in the spinal cord was found to be predictive of disease progression18
Research indicates that Grey Matter pathology may be more strongly correlated with cognitive and physical impairment than White Matter pathology.12,13,19
Imaging studies that examined a number of key MRI parameters found that Grey Matter atrophy was the single strongest MRI correlate of both clinical disability and cognitive impairment in MS patients.13,19
Long Term
59%
A 20-year longitudinal study (n=73) found that Grey Matter atrophy was more strongly correlated with clinical disability over time compared with White Matter atrophy.19
In the same study, patients were 59% less likely to be in a more severe Expanded Disability Status Scale (EDSS) category for every 1 standard deviation increase in their Grey Matter volume.19
“. . .these data suggest that GM atrophy has more clinical relevance in the long term than either lesion load or WM atrophy . . . ”
—Fisniku et al19
Short Term
Grey Matter atrophy explained physical disability better than White Matter atrophy or even whole brain volume loss.12
View references on Grey Matter atrophy.
In a 5-year, prospective, longitudinal study (n=312), MS patients with high cortical lesion load had the worst physical and cognitive prognosis compared with all other patient groups.13
In a 3-year prospective study (n=107), cortical lesion volume was found to be a strong independent predictor of declining physical disability.14
86%
Research indicates that Grey Matter pathology may be more strongly correlated with cognitive and physical impairment than White Matter pathology.12,13,19
In a 5-year longitudinal study (n=312), cortical lesion load was a stronger predictor of physical and cognitive decline than White Matter lesion load.13
“. . .our data strengthen the concept that disability progression in multiple sclerosis is more related to GM than to WM pathology, in all disease phenotypes.”13
View references on Grey Matter lesions.
—Bö et al23
In multiple sclerosis (MS), the relationship between White Matter and Grey Matter pathologies in the central nervous system has not been clear.21 However, evidence suggests that the 2 pathologies can be separate and distinct.21-23
Using postmortem, in vivo MRI, and MR spectroscopy techniques, researchers have examined MS activity and observed that White Matter pathology and Grey Matter pathology appear to be largely independent processes.22,23
Cortical atrophy can be present in the absence of visible White Matter or Grey Matter lesions.23
In a 5-year prospective study (n=312), MS patients who experienced disease progression had significant increases in the volume and number of cortical lesions, but no significant increase in the volume or number of White Matter lesions.13
View references on Grey Matter independent pathology.