Abstract Details

Title It's Not Always Black and White: The "Dirty Grey" Shade of Multiple Sclerosis

Topic MS and Related Diseases

Presentation(s) P06 - (-)

Poster/Presentation
Number 110

Objective

Background BACKGROUND: The application of new, non-conventional magnetic resonance imaging techniques have allowed for improved visualisation of damaged grey matter tissue. The recent technological advancements of Double Inversion Recovery and our growing experience on the identification of cortical abnormalities have not only made lesion detection more accurate, but have also revealed areas of unexplained diffuse and subtle hyperintensity within the cortical grey matter not pertinent to existing lesion categorization.

Design/Methods DESIGN/METHODS: 40 relapsing remitting MS patients and 10 control subjects underwent a magnetic resonance (including double inversion recovery and diffusion tensor imaging sequences) and clinical examination at study entry and after 6 months. "Dirty-appearing grey matter" (DAGM) was defined as hyperintensity of signal located within grey matter, not classifiable according to current categorisations of cortical lesions.

Results RESULTS: Hyperintensities suggestive of DAGM were identified in 27 (67.5%) patients. Areas of DAGM were most prevalent within the insula (89%) and the mesial temporal lobe (hippocampus 100%; amygdala 89%); a few areas of the frontal and temporal lobes and the cingulate were also affected by DAGM. Fractional anisotropy was increase in DAGM compared to normal appearing grey matter. CLs number (p=0.021) and volume (p=0.017) and EDSS score were higher in patients affected by DAGM.

Conclusions CONCLUSIONS: Our results put forward the existence of DAGM in MS. The topographical distribution of DAGM is in line with several histopathological studies demonstrating that the same cortical regions are indeed subject to extensive cortical demyelination and consequent atrophy. Origin and possible clinical implications of this form of grey matter damage have to be further investigated.

Authors/Disclosures
PRESENTER	No disclosure on file
Massimiliano Calabrese, MD (Neuroimmunology Branch, NINDS, NIH)	No disclosure on file
Paolo Gallo, MD (Dompe' Biotec Italy)	Dr. Gallo has nothing to disclose.
Gary R. Cutter, PhD (University of Alabama At Birmingham)	Dr. Cutter has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for onsulting or Advisory Boards: Alexion, Antisense Therapeutics/Percheron, Avotres, Biogen, Clene Nanomedicine, Clinical Trial Solutions LLC, Endra Life Sciences, Cognito Therapeutics, Genzyme, Genentech, Immunic, Klein-Buendel Incorporated, Kyverna Therapeutics, Inc. , Linical, Merck/Serono, Noema, Neurogenesis, Perception Neurosciences, Protalix Biotherapeutics, Regeneron, Revelstone Consulting, Roche, SAB Biotherapeutics, Sapience Therapeutics, Scott&Scott LLP, Tenmile.. Dr. Cutter has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Data and Safety Monitoring Boards: Applied Therapeutics, AI therapeutics, AMO Pharma, Argenx, Astra-Zeneca, Avexis Pharmaceuticals, Bristol Meyers Squibb, CSL Behring, Cynata Therapeutics, DiamedicaTherapeutics, Horizon Pharmaceuticals, Immunic, Inhibrix, Karuna Therapeutics, Kezar Life Sciences, Medtronic, Merck, Meiji Seika Pharma, Mitsubishi Tanabe Pharma Holdings, Prothena Biosciences, Novartis, Pipeline Therapeutics (Contineum), Regeneron, Sanofi-Aventis, Teva Pharmaceuticals, United BioSource LLC, University of Texas Southwestern.. Dr. Cutter has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JASN.

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