Neurol. praxi. 2026;27(2):139-144 | DOI: 10.36290/neu.2026.018

A battle for grey matter: is Ocrelizumab gaining an advantage?

MUDr. Simona Halúsková, Ph.D., MBA, MUDr. Miroslav Mareš, MUDr. Alena Martinková, MUDr. Linda Bláhová, MUDr. Věra Křivková, MUDr. Marek Klíma

Neurologická klinika FZS Univerzity Pardubice a Nemocnice Pardubického kraje, Pardubice

Brain atrophy represents one of the most sensitive markers of neurodegeneration in multiple sclerosis (MS), and its extent closely correlates with long-term disability and cognitive performance. Grey matter atrophy and atrophy of deep brain structures are of particular importance, as they reflect ongoing neurodegeneration more accurately than traditional inflammatory measures. Ocrelizumab, a highly effective anti-CD20 therapy, has been shown to reduce disease activity and slow both global and regional brain tissue loss, including structures that are most vulnerable to neurodegeneration., with a possible impact on preserving the functional reserve of the central nervous system. The available evidence therefore supports the concept of its potential neuroprotective role and highlights the importance of ocrelizumab for the long-term protection of the brain in patients with relapsing-remitting MS.

Keywords: multiple sclerosis, ocrelizumab, brain atrophy, grey matter, cognition.

Received: January 26, 2026; Revised: March 15, 2026; Accepted: March 19, 2026; Prepublished online: March 19, 2026; Published: April 29, 2026  Show citation