Journal of Neurology

, 254:1212

Cortical atrophy is relevant in multiple sclerosis at clinical onset

  • Massimiliano Calabrese
  • Matteo Atzori
  • Valentina Bernardi
  • Aldo Morra
  • Chiara Romualdi
  • Luciano Rinaldi
  • Matthew J. M. McAuliffe
  • Luigi Barachino
  • Paola Perini
  • Bruce Fischl
  • Leontino Battistin
  • Paolo Gallo



Increasing evidence suggests relevant cortical gray matter pathology in patients with Multiple Sclerosis (MS), but how early this pathology begins; its impact on clinical disability and which cortical areas are primarily affected needs to be further elucidated.


115 consecutive patients (10 Clinically Isolated Syndrome (CIS), 32 possible MS (p-MS), 42 Relapsing Remitting MS (RR-MS), 31 Secondary Progressive MS (SP-MS)), and 40 age/gender-matched healthy volunteers (HV) underwent a neurological examination and a 1.5 T MRI. Global and regional Cortical Thickness (CTh) measurements, brain parenchyma fraction and T2 lesion load were analyzed.


We found a significant global cortical thinning in p-MS (2.22 ± 0.09 mm), RR-MS (2.16 ± 0.10 mm) and SP-MS (1.98 ± 0.11 mm) compared to CIS (2.51 ± 0.11 mm) and HV (2.48 ± 0.08 mm). The correlations between mean CTh and white matter (WM) lesion load was only moderate in MS (r = )0.393, p = 0.03) and absent in p-MS (r = )0.147, p = 0.422). Analysis of regional CTh revealed that the majority of cortical areas were involved not only in MS, but also in p-MS. The type of clinical picture at onset (in particular, pyramidal signs/symptoms and optic neuritis) correlated with atrophy in the corresponding cortical areas.


Cortical thinning is a diffuse and early phenomenon in MS already detectable at clinical onset. It correlates with clinical disability and is partially independent from WM inflammatory pathology.

Key words

multiple sclerosis cortical thickness cortical atrophy neuronal degeneration 

Supplementary material

supp1.pdf (149 kb)
Supplemental Material. Regional CTh for all cortical areas analyzed ( Excel file)


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Copyright information

© Steinkopff-Verlag 2007

Authors and Affiliations

  • Massimiliano Calabrese
    • 1
  • Matteo Atzori
    • 1
  • Valentina Bernardi
    • 1
  • Aldo Morra
    • 2
  • Chiara Romualdi
    • 3
  • Luciano Rinaldi
    • 1
  • Matthew J. M. McAuliffe
    • 4
  • Luigi Barachino
    • 2
  • Paola Perini
    • 1
  • Bruce Fischl
    • 5
    • 6
    • 7
  • Leontino Battistin
    • 1
    • 8
  • Paolo Gallo
    • 1
  1. 1.The Multiple Sclerosis Centre of Veneto Region, First Neurology Clinic, Dept. of NeurosciencesUniversity Hospital of PadovaPadovaItaly
  2. 2.Neuroradiology UnitEuganea Medica AlbignasegoPadovaItaly
  3. 3.CRIBI — Biotechnology Centre and Dept. of BiologyUniversity of PadovaPadovaItaly
  4. 4.Biomedical Imaging Research Services Section at the NIHBethesdaUSA
  5. 5.Nuclear Magnetic Resonance CenterMassachusetts General Hospital Harvard Medical SchoolCharlestownUSA
  6. 6.MIT Artificial Intelligence Laboratory, MITCambridgeUSA
  7. 7.Athinoula A Martinos Center, MGH, Dept. of RadiologyHarvard Medical School and Computers Science and AI Lab, MITCambridgeUSA
  8. 8.IRCCS San CamilloLido di VeneziaItaly

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