The neuropathological basis of clinical progression in multiple sclerosis.

Reynolds et al. Acta Neuropathol. 2011 May 28. [Epub ahead of print]

This review highlights the importance of grey matter (GM) involvement in MS, which we think contributes to a lot of the burden of disease. 
“Grey matter pathology is an increasing important area of MS research and an important target for both DMTs and symptomatic therapies. I am sure that grey matter pathology is responsible for the cognitive issues PwMS frequently notice but seldom complain about.”

4 thoughts on “The neuropathological basis of clinical progression in multiple sclerosis.”

  1. Does this mean MS isn't really a white matter disease i.e. just a disease of the white matter? Do current DMT have any effect with regard to grey matter damage?

  2. Re comment MS isn't really a white disease. Yes, it is a disease that involved both white (myelin) and grey (neurones) matter. The grey matter involvement is there from the earliest stages of the disease and is what underlies the cognitive impairment in MS. I suspect it is also involved in MS-related fatigue; i.e. the grey matter of PwMS need to work harder to achieve the same output as people without the disease. This means PwMS tire more easily.

  3. We are not sure yet if DMTs affect grey matter disease. However, I suspect they do as some of the therapies appear to delay grey matter atrophy.

  4. Thanks Prof G.You talk about "grey matter disease" as if it were different from white matter disease. I thought the process was (i) immune attack on mylin / myelin making cells; (ii) damage to axons covered by the mylin resulting in axons being cut (iii) slow death of axons (iv) death of neurons at end of the axons. Is this over-simplistic? I can't believe we actually have a couple of diseases going on! Surely there is a link between the two!

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