Abstract
The early pathological changes in multiple sclerosis suggest that the morphological and functional changes in the cerebral cortex and subcortical gray matter may precede pathological changes in the white matter of the brain. Modern investigational methods allow histopathological analysis of the pathological changes that lead to the early demyelination and atrophy.
New imaging techniques (T2-weighted turbo spin-echo, double inversion recovery MRI - DIR-MRI) or phase-sensitive inversion recovery (PSIR-MRI) allow more detailed detection of cortical pathology. Cortical and subcortical pathology clinically correlates with cognitive disorders, depression, epilepsy and fatigue, compared to white matter changes that correlate with impaired motor skills.
In the future, new techniques may allow MRI to further speed up the diagnosis and early treatment.