MS, Not Just A White Matter Disease Anymore
Submitted by art on Fri, 2007-03-09 07:13.
Neurology has a review article on Gray Matter (GM) involvement in MS. Up until the past several years, MS has been considered a disease of the White Matter, that portion of the brain that has extensive myelin coating. Recent pathology studies have shown that GM is also involved in MS, and have given reason to question the "immune system attacking the myelin" theory of MS.
This review concludes:
- GM involvement and in particular cortical demyelination can be extensive in MS
- GM pathology may occur in part independently of WM lesion formation
- a primarily GM-related process may be the earliest manifestation of MS
- GM involvement is associated with physical disability, fatigue, and cognitive impairment in MS
- GM disease might help explain the observed dissociation between markers of inflammatory demyelination (relapses, WM gadolinium enhancement, WM lesion burden) and disease progression.
In addition, this paper discusses the need to explain the involvement of inflammatory and non-inflammatory processes at work in MS.