Remyelination capacity of the MS brain decreases with disease chronicity
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Medical Update Memo
June 23, 2009
Summary
Canadian researcher Dr. Jack Antel and colleagues report on work in remyelination and recovery. MS is an inflammatory-demyelinating disease of the central nervous system. It is known that demyelinated areas can recover the myelin by an internal repair mechanism of the damaged neural tissue by a process called remyelination. However, little is known about the characteristics of this protective process. The authors of this study aimed to investigate the frequency of remyelination in people with MS with different disease durations and the areas where this protective phenomenon was more prominent. They concluded that remyelination is more prominent in earlier stages of the disease and also that the location of the lesion may influence the extent of the remyelination. Neurology. 2009 Jun 2;72(22):1914-21
Details
The authors objective was to analyze and compare the extent of remyelination in lesions between patients with multiple sclerosis (MS) who have a short (early MS lesions) and a long (chronic MS lesions) disease duration and to determine the influence of anatomic localization on the extent of remyelination. In early MS lesions, remyelination has been described as a relatively frequent event, in contrast to chronic MS lesions, where remyelination is absent or limited to the lesion border in the majority of lesions. However, no studies have been published that have quantified and compared the extent of remyelination in early and chronic MS lesions.
52 biopsies from 51 patients were examined for remyelination (early MS) and in 174 lesions from 36 autopsy cases (chronic MS) by immunohistochemistry for myelin proteins, and findings were correlated with anatomic localization, sex, age, and disease duration.
Significantly more lesions were remyelinated in early than in chronic MS (80.7% vs 60%). In chronic MS, subcortical lesions showed more extensive remyelination than periventricular lesions. The majority of cerebellar lesions were completely demyelinated.
In summary, authors suggest that the data demonstrates that remyelination is a frequent event in early multiple sclerosis lesions. Furthermore, the anatomic localization of a lesion might influence the extent of remyelination.
National Research and Programs
Offert en français.
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