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Updated: Mar 19, 2026

Comprehensive Autopsy Program for Individuals with Multiple Sclerosis

Comprehensive Autopsy Program for Individuals with Multiple Sclerosis

Published on: July 19, 2019

Slowly eroding lesions in multiple sclerosis.

Varun Sethi¹, Govind Nair¹, Martina Absinta¹

¹National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD, USA.

Multiple Sclerosis (Houndmills, Basingstoke, England)

|June 25, 2016

Summary

This summary is machine-generated.

Multiple sclerosis (MS) lesions consistently shrink over time, contrary to assumptions of slow expansion. This sustained radiological contraction suggests tissue loss is the primary pathological process in chronic MS lesions.

Keywords:

Slowly expanding lesion magnetic resonance imaging multiple sclerosis proton density

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Area of Science:

Neuroimmunology
Neuroimaging
Pathology

Background:

Chronic multiple sclerosis (MS) lesions are often described as "slowly expanding" with myelin phagocytosis at the edges.
Current pathological classification relies on static, end-point assessments, hindering direct measurement of lesion expansion rates.

Purpose of the Study:

To investigate long-term volumetric changes in individual MS lesions over time.

Main Methods:

Longitudinal analysis of individual MS lesion volumes using proton density magnetic resonance imaging (MRI) data from 1992-2015.
Correction for acquisition protocols and application of a mixed-effects model to assess lesion volume changes in 22 individuals.

Main Results:

A significant decrease in mean lesion volume was observed over approximately 16 years (from 142 mL to 74 mL).
All measured MS lesions exhibited shrinkage, with no correlation found between lesion volume change and supratentorial brain volume change.
Simulations suggest slow radial expansion combined with rapid tissue resorption could explain the observed shrinkage.

Conclusions:

Sustained radiological contraction of MS lesions was observed, challenging the notion of consistent expansion.
The findings indicate that tissue loss, rather than expansion, is likely the predominant pathological process in chronic MS lesions, even those appearing "slowly expanding" pathologically.