Cortical Involvement in Multiple Sclerosis

It is now well established that cortical lesion detection is important in the diagnosis and prognosis of neurological deficits in patients with multiple sclerosis (MS). In this chapter, the role of in vivo magnetic resonance imaging, both conventional and recently improved, as well as more versatile modalities, together with immunopathological studies to elucidate cortical pathology in MS are introduced. Emphasis is then shifted to the role of animal models of MS and the use of in vitro studies to further understand the cellular interactions between neural and both adaptive and innate arms of the immune system in mediating demyelination and the varying forms of neuronal damage involved in the evolution, progression, and potential remission of neuroinflammatory lesions in MS. The use of current disease-modifying drugs in the treatment of MS is put into context, along with perspectives on the future development of new more selective therapeutic interventions.