Graphic of a brain

Historical Matters: The Era of MS as a White Matter Disease

#Imaging #Lesions

Multiple sclerosis (MS) has classically been considered a White Matter (WM) disease due to the identification of focal demyelinating lesions in WM.1

While the importance of Grey Matter (GM) in disease activity has received more attention in recent years, WM remains an important focus area of MS research.2,3

Human awareness of WM spans further back than knowledge of MS. Here, we take a look at the important milestones in the history of WM and its role in MS.

The Evolution of Our Understanding

Explore the timeline below that highlights just a few of the pivotal discoveries made throughout history that shaped the way we see White Matter today:

Icon of a brain denoting the discovery of WM inside the brain


Discovering White Matter

Vesalius first documents WM in La Fabrica, an illustrated compendium of anatomy.4


Myelinated Fibers

Van Leeuwenhoek describes myelinated fibers, which had first been reported during the renaissance as WM inside the brain.4

Icon of myelinated fibers, that were first reported as white matter inside the brain
Icon denoting the link between white matter and grey matter


A Notable Link

Ehrenberg points to the connection between WM and GM, and between the spine and peripheral nerves.4

1835 to 1842

Locating Lesions

Cruvielhier and Gowers indicate that CNS lesions are most often found in WM such as the periventricular area, corpus callosum, and posterior cranial fossa.5

Icon of locating lesions in white matter in the brain
Icon of a brain denoting the defining of the pathology of multiple sclerosis


Defining MS

Carswell is the first to define the pathology of multiple sclerosis, illustrating WM and GM lesions in the spinal cord, pons, and medulla.5


A White Matter Disease

Multiple sclerosis is considered to be mostly a disease marked by damage to WM, due to difficulty in visualizing GM in postmortem studies and magnetic resonance imaging (MRI).2

Icon of first commercial magnetic resonance imaging on the white matter timeline
Icon of publications inferring that white matter lesions cause impairment in higher-order functions


White Matter Impact

Geschwind publishes the idea that WM lesions cause impairment in higher-order functions.6


Visualizing White Matter

The first time the brain is visible through MRI, showing the separation of WM and GM and demyelinating lesions.5

Icon of Double Inversion Recovery on the white matter timeline
Icon of white matter's focus in multiple sclerosis studies


A Featured Focus

WM remains a major focus in the study of multiple sclerosis, with close to 300 publications indexed on the topic of this disease this year.3

An Evolving Matter

Along with our general understanding of the human brain, knowledge about the neurological activity underlying in MS continues to evolve. It’s clear that WM, along with GM, will continue to be a major focus of research and consideration for clinical practice.

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