Cortical lesions and GA
https://www.sciencedirect.com/science/a ... 4818304942
... The components, common feature and activities of cortical lesions (CLs) have been characterized in several neuropathological and MRI studies which have clearly demonstrated that GM lesions, contrary to that of WM, are not associated with high level of cortical inflammatory infiltrates but mainly with microglia activity and meningeal inflammation, and therefore their sensitivity to the immune-modulatory treatment may be completely different respect to WM lesions
... CLs have been demonstrated consistently in patients with relapsing-remitting RRMS at early stages, sometimes at clinical onset and even in those with symptoms or signs suggestive of MS but having normal appearing WM on conventional MRI
... In addition to discrete lesions, expression of a focal damage, several studies have also shown the presence of a diffuse pathological process involving the entire cortical and deep grey matter. Such a process appears to occur since the early phases of MS and to be correlated to physical and cognitive disability.