Journal of Neurology

, Volume 261, Issue 9, pp 1715–1725 | Cite as

Patterns of regional gray matter and white matter atrophy in cortical multiple sclerosis

  • Laura Parisi
  • Maria A. Rocca
  • Flavia Mattioli
  • Gianna C. Riccitelli
  • Ruggero Capra
  • Chiara Stampatori
  • Fabio Bellomi
  • Massimo FilippiEmail author
Original Communication


We investigated the patterns of regional distribution of focal lesions, white matter (WM) and gray matter (GM) atrophy in patients with cortical (cort) MS in comparison to classical (c) MS patients. Nine cort-MS, nine c-MS and nine age-matched healthy controls (HC) underwent a brain MRI exam, including FLAIR and high-resolution T1-weighted scans. MS patients underwent neurological and neuropsychological assessment. Between-group differences of GM and WM volumes and their correlations with neuropsychological performances were assessed with voxel-based morphometry. FLAIR and T1 lesion probability maps (LPMs) were also obtained. Performance at neuropsychological tests was worse in cort-MS than in c-MS patients. Compared to HC, MS patients had a distributed pattern of GM and WM atrophy. No GM/WM area was more atrophic in c-MS vs cort-MS patients. Compared to c-MS, cort-MS patients experienced GM atrophy of frontal–temporal–parietal areas and cingulate cortex and WM atrophy of the cingulum bundle, bilateral cerebral peduncles, right inferior longitudinal fasciculus and left superior longitudinal fasciculus. FLAIR and T1 LPMs did not differ between c-MS vs cort-MS patients. A higher susceptibility to neurodegenerative processes in key brain regions known to be related to cognitive functions is likely to underlie the clinical manifestations of cort-MS.


Cortical multiple sclerosis MRI Regional damage White matter Gray matter 


Conflicts of interests

Laura Parisi, Flavia Mattioli, Ruggero Capra, Chiara Stampatori, and Fabio Bellomi report no disclosures.

Maria A. Rocca received speakers honoraria from Biogen Idec, Novartis and Serono Symposia International Foundation and receives research support from the Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla.

Massimo Filippi serves on scientific advisory board for Teva Pharmaceutical Industries; has received compensation for consulting services and/or speaking activities from Bayer Schering Pharma, Biogen Idec, Merck Serono, and Teva Pharmaceutical Industries; and receives research support from Bayer Schering Pharma, Biogen Idec, Merck Serono, Teva Pharmaceutical Industries, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla, Cure PSP, and the Jacques and Gloria Gossweiler Foundation (Switzerland).

Ethical standard

This study was approved by the Local Ethical Committes on human studies and written informed consent from each subject was obtained prior to their enrolment.

Statement of Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Laura Parisi
    • 1
  • Maria A. Rocca
    • 1
    • 2
  • Flavia Mattioli
    • 3
  • Gianna C. Riccitelli
    • 1
  • Ruggero Capra
    • 4
  • Chiara Stampatori
    • 3
  • Fabio Bellomi
    • 3
  • Massimo Filippi
    • 1
    • 2
    Email author
  1. 1.Neuroimaging Research Unit, Institute of Experimental Neurology, Division of NeuroscienceSan Raffaele Scientific Institute, Vita-Salute San Raffaele UniversityMilanItaly
  2. 2.Department of NeurologySan Raffaele Scientific Institute, Vita-Salute San Raffaele UniversityMilanItaly
  3. 3.Clinical NeuropsychologySpedali Civili of BresciaBresciaItaly
  4. 4.Multiple Sclerosis CenterSpedali Civili of BresciaBresciaItaly

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