MRI measures of neurodegeneration in multiple sclerosis: implications for disability, disease monitoring, and treatment

Magnetic resonance imaging (MRI) techniques, such as T2-weighted and gadolinium-enhanced T1-weighted sequences, have long been used to diagnose multiple sclerosis (MS). However, these methods are limited in their ability to depict underlying disease pathology. A PubMed literature search was conducted to identify the publications discussing MRI in MS from 2010 to 2013, using the medical subject heading terms: "multiple sclerosis" and "grey/gray matter", "brain atrophy", "grey/gray matter atrophy", "normal appearing white matter," and "cortical lesions." Recent proceedings of conferences on MRI were also used to identify emerging techniques. MRI-derived metrics can assess the microstructural, metabolic, and functional changes that occur in newly formed lesions and allow further characterization of diffuse degeneration in different central nervous system compartments across MS phenotypes. Advanced imaging techniques aim to complement our understanding of MS disease pathophysiology, which may facilitate the identification of markers that could be used to predict the clinical outcomes of agents in development.