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Cortical demyelination in PML and MS: Similarities and differences.

N M Moll1, A M Rietsch, A J Ransohoff

  • 1Neuroinflammation Research Center, Department of Neurosciences, Lerner Research Institute and Neurological Institute, Cleveland Clinic NC-30, 9500 Euclid Avenue, Cleveland, OH 44195, USA.

Neurology
|October 5, 2007
PubMed
Summary

Cortical pathology is a distinct feature of progressive multifocal leukoencephalopathy (PML). This study compared PML and multiple sclerosis (MS) cortical lesions, noting similarities and differences in demyelination and neuritic pathology.

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Area of Science:

  • Neuropathology
  • Neuroimmunology
  • Infectious Neurology

Background:

  • Multiple sclerosis (MS) and progressive multifocal leukoencephalopathy (PML) are demyelinating diseases affecting the central nervous system.
  • Cortical involvement is increasingly recognized in MS, but its characteristics in PML are less understood.

Purpose of the Study:

  • To characterize and compare the pathological changes in the cerebral cortex of patients with PML and MS.
  • To investigate the distribution, inflammatory activity, and neuritic pathology of cortical lesions in PML and MS.

Main Methods:

  • Autopsy brain tissue analysis from patients with PML, MS, and controls.
  • Immunohistochemistry for myelin, inflammatory cells, and neurofilaments.
  • Confocal microscopy to examine neuritic pathology in PML cortical lesions.

Main Results:

  • MS brain tissue showed leukocortical, intracortical, and subpial cortical demyelination.
  • PML brain tissue exhibited intracortical and leukocortical lesions, but not subpial.
  • Cortical lesions in both PML and MS had reduced inflammatory cells compared to white matter lesions.
  • Neuritic pathology, including dystrophic and transected neurites, was observed in PML cortical lesions, similar to MS.

Conclusions:

  • Cortical pathology is a distinct characteristic of PML.
  • Comparing cortical pathology in PML and MS provides insights into the pathogenesis of both diseases.