In multiple sclerosis (MS), cortical damage is a relevant predictor of clinical disability. We applied Neurite orientation dispersion and density imaging (NODDI) to characterize microstructure of normal-appearing cortex (NA-cortex) and cortical lesions (CLs) and their relations with disease clinical phenotypes and disability. We found that a significant neurite loss occurs in MS NA-cortex, being more severe with longer disease duration, more severe disability and progressive MS. CLs show a further reduction of neurite density, together with an increased extracellular space, possibly due to inflammation and gliosis, and a reduced dispersion suggestive of increased tissue coherence and simplification of neurite complexity.
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