Remyelinated Lesions in Multiple Sclerosis

Abstract

THE CENTRAL hallmark of multiple sclerosis (MS) is the presence of multifocal areas of demyelination. Magnetic resonance imaging (MRI) is very sensitive in the detection of MS lesions, and is commonly applied for diagnostic purposes.¹ T2-weighted sequences depict almost any alteration in brain tissue composition and therefore lack histopathologic specificity; this may explain why measures of T2 lesion load correlate poorly with the degree of clinical disability.² Several putative MRI markers (eg, T1 hypointensity and decreased magnetization transfer ratio [MTR]) have been suggested to be more specific for the degree of matrix destruction and axonal loss, the most likely correlate of persistent disability.³