The brain is made up of two types of tissue: grey matter and white matter. For many years, research in multiple sclerosis (MS) focused primarily on white matter, which is where the majority of brain lesions occur. But research has evolved, and experts now understand that grey matter also plays a critical role in MS.


Advancements in MRI technology reveal new information

Thanks to advancements in magnetic resonance imaging (MRI), MS healthcare experts are able to identify changes happening in grey matter—as they relate to MS—in more detail. For example, we now know that grey matter lesions, as well as a decrease in grey matter (also known as brain volume loss), are closely associated with physical and cognitive changes caused by MS. Cognitive changes can include worsening memory, difficulty concentrating, or trouble thinking of the right word.

Evolving research ties grey matter lesions to MS progression

According to recent studies, MS lesions in grey matter may be more closely associated with physical disability and cognitive changes than lesions in white matter. “Grey matter loss is one of the best predictors of disease progression in people with MS,” says Dr. John DeLuca, a senior vice president for research and training at the Kessler Foundation. “Finally, we’re seeing data that may help us better understand the mechanisms that drive this disease.”

By studying grey matter, we’ve become smarter about cognitive impairment in MS

Dr. DeLuca also believes there is value in further study of the relationship between grey matter and cognitive issues in MS. Currently, the majority of research focuses on physical disability. However, up to 65% of people with MS will experience some degree of cognitive damage due to disease progression. According to a recent survey from the Multiple Sclerosis Association of America (MSAA), which was sponsored by Celgene, 78% of people with MS are concerned that cognitive impairment will happen to them.

cognitive loss

A focus on grey matter can help doctors monitor MS more closely

Dr. DeLuca says the time has come for doctors to consider using grey matter loss as a predictor of disability and cognitive impairment. “Grey matter loss could be a trigger for clinicians to watch their patients over time to monitor for potentially related problems. …The more specific we can be regarding the role of grey matter loss, the better we can care for patients with MS.”

If you’re living with MS, talk to your MS healthcare team about the importance of changes in grey matter. You can find a list of questions to ask at your next appointment by visiting

A focus on the role of lesions in grey matter, and the impact of losing grey matter volume, is part of a new initiative called the MS MindShift. This initiative is designed to offer a new perspective on the role the brain plays in MS and help how people with MS live with their disease going forward. Learn more at

How Grey Matter Affects MS

Discover how lesions in grey matter impact MS progression.

© 2019 Celgene Corporation 05/19 US-CLG-19-0706

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