Extensive cortical remyelination in patients with chronic multiple sclerosis
Extensive cortical remyelination in patients with chronic multiple sclerosis
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DOI：
10.1111/j.1750-3639.2006.00043.x
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发表时间：
2007-04-01
期刊：
影响因子：
6.4
通讯作者：
Stadelmann, Christine
中科院分区：
文献类型：
--
作者：
Albert, Monika;Antel, Jack;Stadelmann, Christine
最近的研究显示，慢性多发性硬化症（MS）患者有明显的皮质脱髓鞘。白色病变的脱髓鞘常伴有髓鞘再生。然而，这种修复过程往往是不完整的，并局限于病变边缘。在本研究中，我们研究了33例慢性MS患者尸检脑组织中皮质和白色物质病变髓鞘再生的频率和程度。大多数患者（33例中有29例）具有皮质脱髓鞘。皮质病变的髓鞘再形成通过光镜下薄且不规则排列的髓鞘来识别，并通过电子显微镜证实。18%的皮质病变出现广泛的髓鞘再生，54%的髓鞘再生仅限于病变边缘，28%的皮质病变没有髓鞘再生。直接比较同一患者的白色物质和皮质病变的髓鞘再生程度，发现皮质病变的髓鞘再生始终更广泛。此外，在“正常出现的皮质”区域中纤维的g-比率产生与髓鞘再生一致的值。我们的数据证实了皮质脱髓鞘在慢性MS中的高患病率，并暗示皮质MS病变的髓鞘再生倾向高。
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.