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Advances in multiple sclerosis imaging: neurocognitive imaging

Makki A Almuntashri and Richard I Aviv

Multiple sclerosis (MS) is the most common inflammatory demyelinating disease of the CNS and the most frequent cause of nontraumatic neurological disability in young and middle-aged adults in North America. MRI plays an important role in diagnosing and monitoring patients with MS; however, current conventional MRI is limited in detecting lesions such as cortical-based plaques. Structural MRI may also be insufficient to explain all neurological presentations in patients with MS, particularly cognitive symptoms. Advanced MRI techniques such as diffusion-weighted imaging, diffusion tensor imaging, functional MRI, magnetization transfer, magnetic resonance (MR) perfusion imaging and MR spectroscopy facilitate a greater understanding of the underlying pathophysiology of MS. This article will provide an overview on the role of imaging in MS, focusing on advanced MR sequences and neurocognitive correlation.