Neurology and Preclinical Neurological Studies - CONy Pro/Con debate
The precise pathogenesis of multiple sclerosis is unknown. The assumption of a primary immunopathogenesis of the disease is seriously flawed and has failed to deliver an effective therapy for most patients. The progressive degeneration of grey and white matter is integral to the natural history of the disease and is reflected in the atrophy of brain and spinal cord. Demyelination is an essential component of this primary neurodegenerative process rather than the target of a systemic immune response. The primary pathology of multiple sclerosis is a process of neurodegeneration based on the integrity of the blood–brain barrier. Primary progressive multiple sclerosis is the prototype neurodegenerative disease, and the relapsing-remitting form in younger population represents the modifying effect of steroids (vitamin D, sex and stress hormones) on metabolic functions of the central nervous system.
Atrophy Axons Demyelination Degeneration Immunity Multiple sclerosis Vitamin D
This is a preview of subscription content, log in to check access.
Barcellos LF, Kamdar BB, Ramsay RP et al (2006) Clustering of an autoimmune diseases in families with a high-risk for multiple sclerosis: a descriptive study. Lancet Neurol 5:924–931PubMedCrossRefGoogle Scholar
Barnett MH, Prineas JW (2004) Relapsing and remitting multiple sclerosis: pathology of the newly forming lesion. Ann Neurol 55:458–468PubMedCrossRefGoogle Scholar
Broadley SA, Deans J, Sawcer SJ, Clayton D, Compston DAS (2000) Autoimmune disease in the first-degree relatives of patients with multiple sclerosis: a UK survey. Brain 123:1102–1111PubMedCrossRefGoogle Scholar
Etemadifar M, Abtahi SH, Akbari M et al (2012) Multiple sclerosis and amyotrophic lateral sclerosis: is there a link? Mult Scler 18:902–904PubMedCrossRefGoogle Scholar
Ismail A, Cooper-Knock J, Highley JR et al (2013) Concurrence of multiple sclerosis and amyotrophic lateral sclerosis in patients with hexanucleotide repeat expansions of C9ORF72. J Neurol Neurosurg Psychiatry 84:79–87PubMedCrossRefGoogle Scholar
Landtblom AM, Riise T, Boiko A, Soderfeldt B (2002) Distribution of multiple sclerosis in Sweden based on mortality and disability compensation statistics. Neuroepidemiology 21:167–179PubMedCrossRefGoogle Scholar
Shirani A, Zhao Y, Karim ME et al (2012) Association between use of interferon beta and progression of disability in patients with relapsing remitting multiple sclerosis. JAMA 308:247–256PubMedCrossRefGoogle Scholar
Trapp BD, Nave K-A (2008) Multiple sclerosis: an immune or neurodegenerative disorder? Annu Rev Neurosci 31:247–269PubMedCrossRefGoogle Scholar
van Doormaal PTC, Gallo A, van Rheenen W et al (2013) Amyotrophic lateral sclerosis is not linked to multiple sclerosis in a population based study. J Neurol Neurosurg Psychiatry. doi:10.1136/jnnp-2012-304864Google Scholar