Along with well-characterized abnormalities in normal appearing and lesional white matter, gray matter (GM) pathology has been observed in multiple sclerosis (MS) both with diffusion tensor imaging (DTI) and structural MRI. We used diffusion kurtosis imaging (DKI), a clinically feasible extension of DTI, to characterize pathology in cortical and subcortical GM in MS and uncovered correlations with disease severity, quantified in terms of the Patient Determined Disease Score (PDDS). Our results suggest that DKI metrics are sensitive to changes in GM and could be helpful to use alongside standard markers of disease progression, such as GM volume atrophy.
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