Low degree of cortical pathology is associated with benign course of MS

In this study from Italy, they present the results from the 6-year extension of the previous 1-year prospective longitudinal study on the evolution of cortical pathology in a group of MS patients with relatively mild disease (>15 years duration and EDSS <3), compared with a group of relapsing-remitting MS patients. Results detected 70.5% cortical lesions in early RRMS and 53.3% in benign MS at baseline. After 6 years, new cortical lesions were observed in 84.2% of the early RRMS and in 55.5% of the benign MS patients. In addition to this, cortical thinning had increased significantly in several cortices in RRMS, however, in those with benign MS, only in the occipital-temporal and superior parietal gyrus.

Overall, this study shows significant cortical sparing in MS patients who have the most favourable clinical course. Patients with classical RRMS accumulate both focal and diffuse cortical damage, which may explain why the majority of these patients progress to the secondary progressive phase. This raises the question of evaluating grey matter damage in addition to white matter damage, in order to increase the accuracy in identifying any possible favourable courses in MS.

Calabrese M, Favaretto A, Poretto V

Mult Scler. 2012 Oct 15. [Epub ahead of print]

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