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Updated: Feb 7, 2026
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Cortical and meningeal pathology in progressive multiple sclerosis: a new therapeutic target?
Berenice Anabel Silva1,2, Carina Cintia Ferrari1,3
1Institute of Basic Science and Experimental Medicine (ICBME), University Institute, Italian Hospital, Potosi 4240 (C1199ABB), CABA, Buenos Aires, Argentina.
Abstract:
Multiple sclerosis (MS) is an inflammatory and neurodegenerative disease that involves an intricate interaction between the central nervous system and the immune system. Nevertheless, its etiology is still unknown. MS exhibits different clinical courses: recurrent episodes with remission periods ('relapsing-remitting') that can evolve to a 'secondary progressive' form or persistent progression from the onset of the disease ('primary progressive'). The discovery of an effective treatment and cure has been hampered due to the pathological and clinical heterogeneity of the disease. Historically, MS has been considered as a disease exclusively of white matter. However, patients with progressive forms of MS present with cortical lesions associated with meningeal inflammation along with physical and cognitive disabilities. The pathogenesis of the cortical lesions has not yet been fully described. Animal models that represent both the cortical and meningeal pathologies will be critical in addressing MS pathogenesis as well as the design of specific treatments. In this review, we will address the state-of-the-art diagnostic and therapeutic alternatives and the development of strategies to discover new therapeutic approaches, especially for the progressive forms.
Insights
Multiple sclerosis (MS) is a complex inflammatory and neurodegenerative disease. Understanding its heterogeneous nature and developing new treatments, particularly for progressive forms, remains a critical challenge.
Area of Science:
- Neurology
- Immunology
- Neuroinflammation
Background:
- Multiple sclerosis (MS) is an inflammatory and neurodegenerative disease with unknown etiology.
- MS presents with diverse clinical courses, including relapsing-remitting, secondary progressive, and primary progressive forms.
- Cortical lesions and meningeal inflammation are observed in progressive MS, contributing to physical and cognitive decline.
Purpose of the Study:
- To review current diagnostic and therapeutic strategies for multiple sclerosis.
- To explore the pathogenesis of cortical lesions and meningeal inflammation in MS.
- To discuss the development of novel therapeutic approaches, focusing on progressive MS.
Main Methods:
- Literature review of diagnostic and therapeutic alternatives in MS.
- Analysis of current understanding of MS pathogenesis, including cortical and meningeal involvement.
- Discussion of strategies for discovering new therapeutic approaches for progressive MS.
Main Results:
- The pathological and clinical heterogeneity of MS complicates treatment and cure discovery.
- Progressive MS forms exhibit cortical lesions and meningeal inflammation, not fully described pathogenetically.
- Animal models are crucial for studying MS pathogenesis and designing targeted treatments.
Conclusions:
- Effective treatments for MS, especially progressive forms, are hindered by disease heterogeneity.
- Further research into cortical and meningeal pathologies is essential for advancing MS treatment.
- Development of specific animal models is critical for understanding MS pathogenesis and therapeutic strategies.
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