Cortical Lesions


About this study

The hallmark of MS is white matter lesion formation. However, there is increased evidence for gray matter (cortical) involvement and we hypothesize that these cortical lesions are present in patients even in early MS, and may directly determine the location of white matter lesion formation, as well as contribute to cognitive dysfunction in MS. Double inversion recovery (DIR) MRI sequences have been described in multiple adult multiple sclerosis studies to be sensitive for cortical lesions. These images can be obtained on 3 Tesla MRI scanners, using a non-invasive protocol that has been in place at Mayo Clinic. If such cortical lesions are truly present in early MS, we anticipate to capture a subset of those using DIR techniques, including a novel DIR sequence available to us through our collaboration with Dr. John Port in the Department of Radiology. We also are testing the hypothesis whether cortical lesions directly determine the location of white matter lesion formation, resulting in being directly connected to white matter lesions through white matter tracts, which would revolutionize our understanding of MS pathogeneses. This will be done using diffusion tensor imaging (DTI)-based tractography coupled with analysis of the DIR images. DTI is a standard MRI technique at Mayo Clinic . DTI images can make connecting nervous system tracts visible and will allow to see whether white and grey matter lesions are connected. In addition, as part of our MRI protocol, we will also obtain high resolution T1 weigthed images, which will enable cortical thickness measurements to be perfromed and correlated with the location of gray matter lesions.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.


The first group will consist of 100 early RR-MS and high-risk CIS cases.

The two control groups consist of 20 healthy, age and gender matched individuals (negative controls); and 30 patients with unrelated CNS diseases enriched for the presence of T2W hyperintense lesions (positive MRI control group which includes patients with migraine, small vessel ischemic disease, early vascular dementia and minimal cognitive impairment (MCI)).


Patients with anxiety or claustrophobia, and pregnant patients will be excluded

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status

Rochester, Minn.

Mayo Clinic principal investigator

John Port, M.D., Ph.D.

Closed for enrollment

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