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Think MS, think cortex?
It has always been difficult to assess cortical involvement in multiple sclerosis (MS)at an early stage as lesions tend to remain hidden from MRI. Investigators studied early MS among a cohort of 563 patients who had a brain biopsy (to rule out diseases other than MS) within days or weeks after presentation. 53/138 (38%) who eventually were diagnosed with MS had histological evidence of cortical demyelination. The lesions were inflammatory and associated with meningeal inflammation. This may contribute to disability independently from white matter lesion load.
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