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Histopathology of multiple sclerosis lesions detected by magnetic resonance imaging in unfixed postmortem central
J Newcombe1, C P Hawkins, C L Henderson
1Multiple Sclerosis Society Laboratory, Institute of Neurology, London, UK.
Abstract:
Postmortem unfixed whole brains from 17 multiple sclerosis and 6 control cases were examined by magnetic resonance imaging (MRI) using a T2-weighted spin echo sequence and histology to determine the relationship between areas of abnormal MRI signal and underlying pathological change. In group 1, small MRI lesions and correspondingly small plaques, most of which were chronic, were detected histologically in 5 brains. In 4 brains there were more extensive areas of both abnormal signal and histological plaques which were more often active (group 2). However, in a further 5 brains extensive MRI abnormalities were observed when only small periventricular plaques were present histologically (group 3). Lesions in the hindbrain and cerebral grey matter were infrequently observed by MRI. The extensive MRI abnormalities seen in areas in which only small histological plaques were found may be the result of vascular permeability changes in the normal-appearing white matter surrounding plaques.
Insights
Magnetic resonance imaging (MRI) in multiple sclerosis (MS) brains revealed that extensive MRI abnormalities may not always correlate with large plaque size. Some normal-appearing white matter surrounding plaques may show increased vascular permeability, contributing to MRI signal changes.
Area of Science:
- Neuroimaging
- Neuropathology
- Multiple Sclerosis Research
Background:
- Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system.
- Accurate assessment of lesion load and activity in MS is crucial for understanding disease progression and treatment efficacy.
- The relationship between magnetic resonance imaging (MRI) findings and histological pathology in postmortem MS brains requires further elucidation.
Purpose of the Study:
- To investigate the correlation between abnormal MRI signals and histological pathological changes in postmortem multiple sclerosis (MS) brains.
- To determine if MRI accurately reflects the extent and activity of MS plaques.
- To explore potential reasons for discrepancies between MRI findings and histology.
Main Methods:
- Postmortem unfixed whole brains from 17 MS cases and 6 controls were analyzed.
- Magnetic resonance imaging (MRI) using a T2-weighted spin echo sequence was performed.
- Histological examination was conducted to identify and characterize demyelinating plaques.
Main Results:
- Group 1: Small MRI lesions correlated with small, mostly chronic, histological plaques.
- Group 2: More extensive MRI abnormalities corresponded to larger, often active, histological plaques.
- Group 3: Extensive MRI abnormalities were observed despite only small periventricular plaques histologically, suggesting other contributing factors like vascular permeability changes in normal-appearing white matter.
Conclusions:
- MRI findings in multiple sclerosis (MS) brains do not always directly mirror the size of histological plaques.
- Extensive MRI abnormalities can occur in the presence of small plaques, potentially due to changes in the surrounding normal-appearing white matter.
- Further research is needed to understand the mechanisms underlying MRI signal changes in MS, particularly concerning vascular permeability.