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The Neuropathology of Progressive Multiple Sclerosis

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Progressive Multiple Sclerosis

Abstract

The neuropathological findings in progressive MS support the hypothesis that neuroaxonal loss is the major substrate of progressive disability. Neuroaxonal injury appears to be initiated within focal regions of inflammatory demyelination. However, it is possible that at a certain stage, other factors ensue, which result in neurodegeneration persisting in the absence of ongoing demyelination. Such factors might include compartmentalized low-grade inflammation, loss of trophic support provided by myelin, oligodendrocytes, and astrocytes, and an energy-deficient state induced by sodium channel redistribution and mitochondrial depletion. Axonal degeneration may be paralleled by a declining capacity for repair, failure to remyelinate, and ongoing gliosis. Ultimately, a shift in the balance between injury and repair is likely to result in the numbers of functioning axons falling below a required threshold, causing permanent disability.

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Authors and Affiliations

  1. Department of Neurology, Haukeland University Hospital, National Competence Center for Multiple Sclerosis, Bergen, Norway

    Lars Bo

  2. Division of Clinical Neurology, Nottingham University Hospital, Queen’s Medical Centre, Derby Road, Nottinghamshire, NG7 2UH, Nottingham, UK

    Nikos Evangelou M.D., D.Phil.

  3. Division of Clinical Neurology, Nottingham University Hospital, University of Nottingham, Nottingham, UK

    Emma Tallantyre

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  1. Lars Bo
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  2. Nikos Evangelou M.D., D.Phil.
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  3. Emma Tallantyre
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Correspondence to Nikos Evangelou M.D., D.Phil. .

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Editors and Affiliations

  1. , Department of Neurology, Frenchay Hospital, Frenchay Park Road, Bristol, BS16 1LE, United Kingdom

    Alastair Wilkins

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Bo, L., Evangelou, N., Tallantyre, E. (2013). The Neuropathology of Progressive Multiple Sclerosis. In: Wilkins, A. (eds) Progressive Multiple Sclerosis. Springer, London. https://doi.org/10.1007/978-1-4471-2395-8_4

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