METHODS: The investigators evaluated the prevalence and character of demyelinating cortical lesions in MS’ers. Cortical tissues were obtained in passing during biopsy sampling of white-matter lesions. In most cases, biopsy was done with the use of stereotactic procedures to diagnose suspected tumors. MS’ers with sufficient cortex (138 of 563 patients screened) were evaluated for cortical demyelination.
RESULTS: Cortical demyelination was present in 53 patients (38%) (104 lesions and 222 tissue blocks) and was absent in 85 patients (121 tissue blocks). Twenty-five patients with cortical demyelination had definite multiple sclerosis (81% of 31 patients who underwent long-term follow-up), as did 33 patients without cortical demyelination (72% of 46 patients who underwent long-term follow-up). In representative tissues, 58 of 71 lesions (82%) showed T-cell infiltrates, and 32 of 78 lesions (41%) showed macrophage-associated demyelination. Meningeal inflammation was topographically associated with cortical demyelination in patients who had sufficient meningeal tissue for study.
|Cortical lesions on MRI in MS|
However, this is not really a paradign shift as claimed on the radio, but is providing evidence that is supportive of things that we thought we knew already.