inflammatory infiltration into the cortex through the meninges underlies MS

[frodo]

A “kissing lesion”: In-vivo 7T evidence of meningeal inflammation in early multiple sclerosis

https://journals.sagepub.com/doi/abs/10 ... 8516683267

Background:

The role of cortical lesions (CLs) in disease progression and clinical deficits is increasingly recognized in multiple sclerosis (MS); however the origin of CLs in MS still remains unclear.

Objective:

Here, we report a para-sulcal CL detected two years after diagnosis in a relapsing-remitting MS (RRMS) patient without manifestation of clinical deficit.

Methods:

Ultra-high field (7T) MR imaging using magnetization-prepared 2 rapid acquisition gradient echoes (MP2RAGE) sequence was performed.

Results:

A para-sulcal CL was detected which showed hypointense rim and iso- to hyperintense core. This was detected in the proximity of the leptomeninges in the left precentral gyrus extending to the adjacent postcentral gyrus.

Conclusion:

This finding indicates that inflammatory infiltration into the cortex through the meninges underlies cortical pathology already in the early stage of disease and in mild disease course.