Present address: Experimental Neuroimmunology, Department of General Neurology, Hertie Institute for Clinical Brain Research, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany.
Extensive Cortical Remyelination in Patients with Chronic Multiple Sclerosis
Article first published online: 22 JAN 2007
© 2007 The Authors
Volume 17, Issue 2, pages 129–138, April 2007
How to Cite
Albert, M., Antel, J., Brück, W. and Stadelmann, C. (2007), Extensive Cortical Remyelination in Patients with Chronic Multiple Sclerosis. Brain Pathology, 17: 129–138. doi: 10.1111/j.1750-3639.2006.00043.x
- Issue published online: 22 JAN 2007
- Article first published online: 22 JAN 2007
Recent studies revealed prominent cortical demyelination in patients with chronic multiple sclerosis (MS). Demyelination in white matter lesions is frequently accompanied by remyelination. This repair process, however, often remains incomplete and restricted to the lesion border. In the present study, we examined the frequency and extent of remyelination in cortical and white matter lesions in autopsy brain tissue of 33 patients with chronic MS. The majority of patients (29 of 33) harbored cortical demyelination. Remyelination of cortical lesions was identified light microscopically by the presence of thin and irregularly arranged myelin sheaths, and confirmed by electron microscopy. Extensive remyelination was found in 18%, remyelination restricted to the lesion border in 54%, and no remyelination in 28% of cortical lesions. A direct comparison of the extent of remyelination in white matter and cortical lesions of the same patients revealed that remyelination of cortical lesions was consistently more extensive. In addition, g-ratios of fibers in areas of “normal appearing cortex” yielded values consistent with remyelination. Our data confirm the high prevalence of cortical demyelination in chronic MS and imply that the propensity to remyelinate is high in cortical MS lesions.