Cerebrospinal fluid

Neuroscience

Biology

Neuroinflammation

Neurodegeneration

White matter

Radiology

Immunology

Meninges

Microglia

Central nervous system

Inflammation

Internal medicine

Multiple sclerosis

Perivascular space

Grey matter

Medicine

Disease

Magnetic resonance imaging

Pathology

Cold Spring Harbor Perspectives in Medicine

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS), which gives rise to focal lesions in the gray and white matter and to diffuse neurodegeneration in the entire brain. In this review, the spectrum of MS lesions and their relation to the inflammatory process is described. Pathology suggests that inflammation drives tissue injury at all stages of the disease. Focal inflammatory infiltrates in the meninges and the perivascular spaces appear to produce soluble factors, which induce demyelination or neurodegeneration either directly or indirectly through microglia activation. The nature of these soluble factors, which are responsible for demyelinating activity in sera and cerebrospinal fluid of the patients, is currently undefined. Demyelination and neurodegeneration is finally accomplished by oxidative injury and mitochondrial damage leading to a state of "virtual hypoxia."

Multiple Sclerosis Pathology