Association between pathological and MRI findings in multiple sclerosis

Lancet Neurol. 2012 Apr;11(4):349-60. doi: 10.1016/S1474-4422(12)70003-0. Epub 2012 Mar 19.


The identification of pathological processes that could be targeted by therapeutic interventions is a major goal of research into multiple sclerosis (MS). Pathological assessment is the gold standard for such identification, but has intrinsic limitations owing to the limited availability of autopsy and biopsy tissue. MRI has gained a leading role in the assessment of MS because it allows doctors to obtain an ante mortem picture of the degree of CNS involvement. A number of correlative pathological and MRI studies have helped to define in vivo the pathological substrates of MS in focal lesions and normal-appearing white matter, not only in the brain, but also in the spinal cord. These studies have resulted in the identification of aspects of pathophysiology that were previously neglected, including grey matter involvement and vascular pathology. Despite these important achievements, numerous open questions still need to be addressed to resolve controversies about how the pathology of MS results in fixed neurological disability.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Brain / pathology*
  • Brain / physiopathology
  • Humans
  • Magnetic Resonance Imaging / classification
  • Magnetic Resonance Imaging / methods*
  • Multiple Sclerosis / pathology*
  • Multiple Sclerosis / physiopathology
  • Optic Nerve / pathology*
  • Optic Nerve / physiopathology
  • Spinal Cord / pathology*
  • Spinal Cord / physiopathology