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Ultrastructure of multiple sclerosis

M Rodriguez1, B Scheithauer

  • 1Department of Neurology, Mayo Clinic, Rochester, Minnesota 55905.

Ultrastructural Pathology
|January 1, 1994
PubMed
Summary
This summary is machine-generated.

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Electron microscopy reveals early myelin damage in multiple sclerosis (MS) lesions. Oligodendrocyte dysfunction is implicated in MS pathogenesis, with remyelination observed at lesion edges.

Area of Science:

  • Neuroscience
  • Pathology
  • Electron Microscopy

Background:

  • Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system characterized by demyelination.
  • Understanding the early cellular events in MS pathogenesis is crucial for developing effective treatments.

Purpose of the Study:

  • To investigate the electron microscopic features of inflammatory demyelination in stereotaxic brain biopsies from multiple sclerosis patients.
  • To elucidate the roles of oligodendrocytes, astrocytes, and inflammatory cells in the early and chronic stages of MS lesions.

Main Methods:

  • Analysis of 11 stereotaxic brain biopsies using electron microscopy.
  • Morphological assessment of myelin sheaths, oligodendrocytes, astrocytes, axons, and inflammatory infiltrates.

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Main Results:

  • Early demyelination involved degeneration of oligodendroglial loops and myelin lamellar widening preceding sheath destruction.
  • Perivascular inflammatory cells (lymphocytes, macrophages, plasma cells) were closely associated with myelin.
  • Chronic lesions showed decreased oligodendrocyte numbers and demyelinated axons, while acute lesions had preserved oligodendrocytes.
  • Evidence of axonal injury (swellings) and central nervous system-type remyelination by oligodendrocytes at lesion edges was observed.
  • Unusual "polelike" inclusions were noted within macrophages.

Conclusions:

  • Disturbance of oligodendrocyte myelinating function appears critical in multiple sclerosis pathogenesis.
  • Early oligodendroglial changes and subsequent demyelination precede complete myelin sheath destruction.
  • Remyelination by oligodendrocytes occurs at the edges of established lesions.