An important part of understanding MRI is knowing how your gray matter is doing. An MS MRI can appear quiet or without disease activity if there are no new lesions in white matter. Meanwhile, gray matter can be atrophying. This is not benign.... This is something which is often overlooked by neurologists. And this is what happens in progressive MS.
I asked the technicians reading Jeff's most recent MRI last May to compare his gray matter to two earlier MRIs. This can be done on standard MRI of 3Tesla. They looked at the width of the third ventricle, the thalamus, and brain stem, and noted that his gray matter appeared more normal on this MRI, and his third ventricle was smaller, and thalamus and brain stem now appear "plumper". This is a reversal of gray matter atrophy. I've written on Facebook about the importance of gray matter, how MS is much more than white matter lesions, and how to help your gray matter.
For those on FB:https://www.facebook.com/note.php?note_ ... 5662517211https://www.facebook.com/notes/ccsvi-in ... 1434857211
Progressive MS does not have white matter lesions, inflammation, and demyelination, yet disability continues. This has baffled MS researchers. Why would the disease progress, without the hallmark inflammation that we see in relapsing remitting MS? What changes when MS becomes progressive?
What if NOTHING changes, and we've simply been monitoring the wrong symptom....the white matter lesions. I've made the comment many times: MS obviously isn't only about white matter lesions, or else how could someone like my husband, with over 20 white matter lesions, still be hiking and biking, when our friend, with one lesion and progressive MS, is using a wheelchair?
Dr. Zivadinov has gone as far as to suggest we redefine disease pathogenesis by looking at gray matter:http://www.biomedcentral.com/1471-2377/12/9
Most neurologists don't even consider gray matter evaluation--but we are learning that this is more and more important. Dr. Zamboni and Dr. Zivadinov suggest that this is linked to cerebral blood flow and perfusion.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3059278/
good luck to all pwMS trying to understand their own disease path, and be your own advocates. White matter is not the whole story...