Reductions in R2t*, a new MRI biomarker, within cortical gray matter (GM) was more sensitive to tissue damage in multiple sclerosis (MS) than atrophy, potentially allowing a reduced sample size in clinical trials, a recent prospective study found. Furthermore, R2t*, together with structural morphometry, suggested topographic patterns of regions showing correlated tissue damage throughout the brain and the cervical spinal cord of MS patients. Researchers examined 44 MS patients and 19 healthy controls (HC) and found:

• R2t* in cortical GM was more sensitive to MS damage than cortical atrophy.
• Using >2 standard deviations (SD) reduction vs age‐matched HC as the cutoff, 48% of MS patients showed lower R2t*, vs only 9% with lower cortical thickness.
• Significant correlations between severities of tissue injury were identified among 1) upper cervical cord and several cortical regions, including motor cortex, and 2) adjacent regions of GM and subcortical white matter (WM).
• R2t*‐defined tissue cellular damage in cortical GM was greater relative to adjacent WM.