Purpose of review: This review summarizes recent advancements in cortical imaging in multiple sclerosis (MS).
Recent findings: New and advanced imaging techniques have been developed to improve cortical lesion detection, measure cortical atrophy and depict diffuse gray matter damage. New pulse sequences have been developed and (ultra) high-field strength has been proven to be advantageous in the visualization of cortical lesions. Unfortunately, there are still many cortical lesions that remain undetected on MR sequences, especially subpial lesions. Combining histopathological findings with MR imaging has provided us with more insight into MS pathogenesis. Cortical atrophy, deep gray matter atrophy and cortical lesions all have diagnostic and prognostic value.
Summary: New and advanced imaging techniques continue to play a pivotal role in the visualization and quantification of cortical damage in MS. It provides us with a better understanding of cognitive functioning and functional reorganization.