There are two types of brain matter
The brain is made up of two types of tissue:
grey matter, which is where communication signals start, and white matter—which carries messages from one area to another. Multiple sclerosis (MS) lesions occur in both of these areas and can lead to the symptoms you experience.
What we now know about the role of grey matter
For many years, researchers focused primarily on white matter when it came to MS. And while white matter is important (about 95% of all MS lesions happen there), recent research has revealed that
lesions and a decrease in grey matter (also known as brain volume loss) can have a much greater impact on MS than once believed.
Grey matter lesions can happen early on
Grey matter lesions can start very early in the disease—even before you experience symptoms.
The progression of MS can be tied to grey matter lesions
Changes in grey matter, such as those caused by lesions, may be more closely associated with a decline in physical ability and cognitive changes (which can include worsening memory, difficulty concentrating, or trouble thinking of the right word) than white matter lesions.
Decreases in the volume of grey matter can help predict long-term disability
As we age, we all lose brain volume naturally. For people with MS, this can happen more quickly. That’s because lesions in both grey and white matter can become scar tissue, which causes the volume of the brain to decrease. A decrease in the volume of grey matter is a strong predictor of long-term physical disability and cognitive issues in MS.
Lesions can change over time
Lesions often progress over time. That’s why identifying them early, and monitoring them regularly, are important. This progress is monitored by using MRI scans. These scans produce three kinds of images.
GdE LESIONS GdE LESIONS Lesions begin as inflammation. These are called GdE (gadolinium-enhancing) lesions. In the GdE MRI, a liquid dye is injected into the body to make areas of inflammation visible. T2 LESIONS T2 LESIONS If inflammation persists, it can lead to new lesions or cause existing lesions to evolve. These are called T2 lesions. They show up as “bright white spots” on an MRI. T1 LESIONS T1 LESIONS Over time, lesions can mature—becoming permanent scars in the brain. These are T1 lesions. They appear as dark areas or “black holes” on an MRI. Neurological reserve: How the brain can adapt to lesion damage
When brain lesions occur, the affected area may no longer function properly. However, other areas can step in and perform the tasks that part of the brain no longer can. This amazing ability to adapt is called “
Neurological reserve can keep you from experiencing symptoms of MS early on. However, this ability doesn’t last forever. It’s important to make healthy lifestyle choices to help maintain neurological reserve for as long as you can. These changes are a key part of preserving your brain and its function.