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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
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Published on: July 19, 2019

Preactive lesions in multiple sclerosis.

Paul van der Valk1, Sandra Amor

  • 1Department of Pathology, VU Medical Center, Amsterdam, The Netherlands. p.vandervalk@vumc.nl

Current Opinion in Neurology
|May 7, 2009
PubMed
Summary
This summary is machine-generated.

Early multiple sclerosis (MS) pathology reveals "preactive lesions" in normal-appearing white matter. These lesions, marked by microglia clusters, may offer insights into halting MS inflammation.

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Area of Science:

  • Neuroimmunology
  • Neuropathology
  • Multiple Sclerosis Research

Background:

  • Advanced pathological, biochemical, and imaging techniques have improved understanding of early multiple sclerosis (MS) changes.
  • Normal-appearing white matter (NAWM) in MS patients exhibits pathological alterations preceding active demyelination.

Purpose of the Study:

  • To review accumulating evidence for early pathological changes in MS, termed 'preactive lesions'.
  • To highlight the characteristics of preactive lesions, specifically activated microglia clusters in NAWM.

Main Methods:

  • Review of current literature on pathological, biochemical, and imaging studies in MS.
  • Analysis of findings related to early white matter changes in MS patients.

Main Results:

  • Evidence supports pathological changes in MS NAWM occurring months to years before active lesions.
  • Preactive lesions are characterized by activated microglia clusters without demyelination or significant leukocyte infiltration.
  • Oligodendrocyte abnormalities are implicated in preactive lesion development, though the exact triggers remain unidentified.

Conclusions:

  • Preactive lesions represent an early stage in the development of destructive MS lesions.
  • The spontaneous resolution of many preactive lesions suggests they are key to understanding and potentially halting MS inflammation.