Surface-in pathology in multiple sclerosis: a new view on pathogenesis?

While multiple sclerosis can affect any part of the CNS, it does not do so evenly. In white matter it has long been recognized that lesions tend to occur around the ventricles, and grey matter lesions mainly accrue in the outermost (subpial) cortex. In cortical grey matter, neuronal loss is greater...

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Veröffentlicht in:Brain (London, England : 1878) Jg. 144; H. 6; S. 1646
Hauptverfasser: Pardini, Matteo, Brown, J William L, Magliozzi, Roberta, Reynolds, Richard, Chard, Declan T
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England 28.07.2021
Schlagworte:
meningeal inflammation
magnetization transfer ratio
multiple sclerosis
neuropathology
B cell follicle
ISSN:1460-2156, 1460-2156
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Zusammenfassung:While multiple sclerosis can affect any part of the CNS, it does not do so evenly. In white matter it has long been recognized that lesions tend to occur around the ventricles, and grey matter lesions mainly accrue in the outermost (subpial) cortex. In cortical grey matter, neuronal loss is greater in the outermost layers. This cortical gradient has been replicated in vivo with magnetization transfer ratio and similar gradients in grey and white matter magnetization transfer ratio are seen around the ventricles, with the most severe abnormalities abutting the ventricular surface. The cause of these gradients remains uncertain, though soluble factors released from meningeal inflammation into the CSF has the most supporting evidence. In this Update, we review this 'surface-in' spatial distribution of multiple sclerosis abnormalities and consider the implications for understanding pathogenic mechanisms and treatments designed to slow or stop them.
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ISSN:1460-2156
1460-2156
DOI:10.1093/brain/awab025