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  Vol. 66 No. 2, February 2009 TABLE OF CONTENTS
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Visualizing the Cause of Gray Matter Atrophy in Multiple Sclerosis

Nancy D. Richert, MD, PhD; Eduard Kraft, MD; Olaf Stüve, MD, PhD

Arch Neurol. 2009;66(2):159-160.

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Until recently, multiple sclerosis (MS) was considered an inflammatory demyelinating disorder of the central nervous system, characterized by axonal sparing. The origin of this misconception is nebulous, and its existence astonishing. Jean Martin Charcot was among the first to recognize the presence of axonopathies in MS. He observed that MS lesions are sometimes located adjacent to cerebral gray matter and that they may infiltrate gray matter, deep nuclei, and the cerebral cortex.1 These observations, along with their confirmation by other investigators, took place 140 years ago. Knowledge of gray matter disease in MS has advanced little since then.

It appears to be intuitive that demyelination and axonal loss, either in isolation or in combination, lead to brain atrophy. The invention of ever-advanced neuroimaging techniques has contributed to our understanding of the natural course of brain shrinkage in MS. . . . [Full Text of this Article]

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