Multiple Sclerosis

08.25.22

Is Multiple Sclerosis a White Matter Disease or A Gray Matter Disease?

David Brandes, MD and Ajay Gupta, MD

Damage to myelin, or white matter, is almost always present in multiple sclerosis and the disease has long been thought of as one in which the immune system attacks myelin. Yet damage to the cell that is wrapped in myelin also occurs. As with the chicken or the egg, the experts debate which comes first—gray matter damage, or white?