Journal of Neurology

, 255:1802

Dirty-appearing white matter in multiple sclerosis

Preliminary observations of myelin phospholipid and axonal loss
  • G. R. W. Moore
  • C. Laule
  • A. MacKay
  • E. Leung
  • D. K. B. Li
  • G. Zhao
  • A. L. Traboulsee
  • D. W. Paty
ORIGINAL COMMUNICATION

DOI: 10.1007/s00415-008-0002-z

Cite this article as:
Moore, G.R.W., Laule, C., MacKay, A. et al. J Neurol (2008) 255: 1802. doi:10.1007/s00415-008-0002-z

Abstract

“Dirty-appearing white matter” (DAWM) in multiple sclerosis (MS) is defined as a region(s) with ill-defined borders of intermediate signal intensity between that of normal-appearing white matter (NAWM) and that of plaque on T2-weighted and proton density imaging. To delineate the histopathology of DAWM, four formalin-fixed cerebral hemisphere slices of three MS patients with DAWM were scanned with T2- weighted and proton density sequences. The myelin water fraction (MWF) was obtained by expressing the short T2 component as a fraction of the total T2 distribution. Hemispheric sections were then stained with Luxol fast blue (LFB) for myelin phospholipids, for myelin basic protein (MBP) and 2’,3’-cyclic nucleotide 3’-phosphohydrolase (CNP) for myelin; Bielschowsky silver impregnation for axons; and for glial fibrillary acidic protein (GFAP) for astrocytes. Compared to NAWM, DAWM showed reduction in MWF, corresponding to a reduction of LFB staining. DAWM also showed reduced Bielschowsky staining. Quantitatively, the change in MWF in DAWM most consistently correlated with the change in LFB staining. The findings of this preliminary study suggest that DAWM is characterized by loss of myelin phospholipids, detected by the short T2 component, and axonal reduction.

Key words

dirty-appearing white matternormal-appearing white mattermultiple sclerosismagnetic resonance imagingmyelin water fraction

Copyright information

© Springer 2008

Authors and Affiliations

  • G. R. W. Moore
    • 1
    • 2
  • C. Laule
    • 4
    • 5
  • A. MacKay
    • 3
    • 4
    • 5
  • E. Leung
    • 2
  • D. K. B. Li
    • 3
    • 5
  • G. Zhao
    • 5
  • A. L. Traboulsee
    • 5
    • 6
  • D. W. Paty
    • 5
    • 6
  1. 1.Dept. of Pathology and Laboratory Medicine (Neuropathology)Vancouver General HospitalVancouver, BCCanada
  2. 2.University of British ColumbiaBritish ColumbiaCanada
  3. 3.Dept. of Radiology, UBC Hospital and Vancouver GeneralHospital and University of British ColumbiaBritish ColumbiaCanada
  4. 4.Dept. of Physics and AstronomyUniversity of British ColumbiaBritish ColumbiaCanada
  5. 5.MS/MRI Research GroupUniversity of British ColumbiaBritish ColumbiaCanada
  6. 6.Dept. of Medicine (Neurology) and Multiple Sclerosis ClinicUBC Hospital VancouverBritish ColumbiaCanada