Aug 5, 2015

Clinical and pathological insights into the dynamic nature of the white matter multiple sclerosis plaque

Annals of Neurology
Josa M FrischerC F Lucchinetti


An extensive analysis of white matter plaques in a large sample of multiple sclerosis (MS) autopsies provides insights into the dynamic nature of MS pathology. One hundred twenty MS cases (1,220 tissue blocks) were included. Plaque types were classified according to demyelinating activity based on stringent criteria. Early active, late active, smoldering, inactive, and shadow plaques were distinguished. A total of 2,476 MS white matter plaques were identified. Plaque type distribution was analyzed in relation to clinical data. Active plaques were most often found in early disease, whereas at later stages, smoldering, inactive, and shadow plaques predominated. The presence of early active plaques rapidly declined with disease duration. Plaque type distribution differed significantly by clinical course. The majority of plaques in acute monophasic and relapsing-remitting MS (RRMS) were active. Among secondary progressive MS (SPMS) cases with attacks, all plaque types could be distinguished including active plaques, in contrast to SPMS without attacks, in which inactive plaques predominated. Smoldering plaques were frequently and almost exclusively found in progressive MS. At 47 years of age, an equilibrium was observed between act...Continue Reading

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Mentioned in this Paper

Mitral Valve Stenosis
Medial Septal Nucleus
Dental Plaque
Multiple Sclerosis, Acute Relapsing
Marginal Sulcus (Human Only)
Carotid Artery Plaque
Mass Spectrometry
Multiple Sclerosis, Progressive Relapsing

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