Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic.
BMC Neurol. 2012 Mar 7;12:10. doi: 10.1186/1471-2377-12-10.
Traditionally, multiple sclerosis has been viewed as a disease predominantly affecting white matter. However, this view has lately been subject to numerous changes, as new evidence of anatomical and histological changes as well as of molecular targets within the grey matter has arisen. This advance was driven mainly by novel imaging techniques, however, these have not yet been implemented in routine clinical practice. The changes in the grey matter are related to physical and cognitive disability seen in individuals with multiple sclerosis. Furthermore, damage to several grey matter structures can be associated with impairment of specific functions. Therefore, we conclude that grey matter damage - global and regional - has the potential to become a marker of disease activity, complementary to the currently used magnetic resonance markers (global brain atrophy and T2 hyperintense lesions). Furthermore, it may improve the prediction of the future disease course and response to therapy in individual patients and may also become a reliable additional surrogate marker of treatment effect.
传统上，多发性硬化症被认为主要影响白质的疾病。然而，最近这种观点发生了许多变化，因为新的证据表明灰质内存在解剖和组织学变化以及分子靶点。这一进展主要是由新的成像技术推动的，然而，这些技术尚未在常规临床实践中实施。灰质的变化与多发性硬化症患者的身体和认知障碍有关。此外，几个灰质结构的损伤可能与特定功能的障碍有关。因此，我们得出结论，灰质损伤 - 整体和局部 - 有可能成为疾病活动的标志物，与目前使用的磁共振标志物（全脑萎缩和 T2 高信号病变）互补。此外，它可以改善对个体患者未来疾病过程和治疗反应的预测，也可能成为治疗效果的可靠替代标志物。
