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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
09:41

Comprehensive Autopsy Program for Individuals with Multiple Sclerosis

Published on: July 19, 2019

Heterogeneity of cortical lesions in multiple sclerosis: clinical and pathologic implications

Evert-Jan Kooi1, Eva M M Strijbis, Paul van der Valk

  • 1Department of Pathology-Neuropathology, VU University Medical Center, Amsterdam, the Netherlands.

Neurology
|September 14, 2012
PubMed
Abstract

Insights

Activated microglia in cortical lesions (CLs) of multiple sclerosis (MS) patients indicate a younger age at death and a more aggressive disease course. This finding highlights the clinical significance of microglia activation in MS pathology.

Area of Science:

  • Neuroscience
  • Immunology
  • Pathology

Background:

  • Cortical lesions (CLs) in multiple sclerosis (MS) typically lack inflammatory markers like lymphocyte/macrophage influx.
  • However, some CLs have been observed to contain activated microglia.

Purpose of the Study:

  • To assess the clinical significance of microglia activation within CLs in a large autopsy sample of MS patients.
  • To investigate the relationship between microglia activation in CLs and other pathological features of MS.

Main Methods:

  • Cross-sectional clinicopathological analysis of 22 MS patients with extensive CLs and 19 MS patients without significant CLs.
  • Categorization of CL patients into those with rims of activated microglia (RAM-CL) and those without.

Main Results:

  • A subset of MS patients (12/22) exhibited RAM-CLs.
  • Patients with RAM-CLs were significantly younger at death (53.5 years) compared to non-RAM-CL (68.7 years) and non-CL (66.9 years) groups.
  • RAM-CL presence correlated with shorter disease duration and a higher number of active white matter lesions.

Conclusions:

  • Rims of activated microglia in CLs (RAM-CLs) are present in a subset of MS patients.
  • RAM-CLs are associated with more active white matter inflammation and a less favorable disease trajectory in MS.

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