Pathology of MS subtypes (RIS, CIS, RRMS, PMS, Balo disease)

      Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system which leads to focal destruction of myelin, acute axonal damage/loss of axons and reactive astrogliosis in the white and grey matter. MS has long time been considered a focal white matter disease, however, nowadays it is accepted that MS involves the entire central nervous system (CNS), including focal white and grey matter lesions as well as the normal-appearing white and gray matter. The pathology of MS lesions changes from early relapsing to chronic progressive disease stages. The presentation discusses the pathological events occurring in the above mentioned three compartments from radiologically isolated syndrome to progressive MS:
      • 1)
        White matter lesion type (inflammation, axonal pathology, remyelination) in early versus progressive MS
      • 2)
        Gray matter involvement (lesion types, neuronal pathology, meningeal inflammation)
      • 3)
        Normal appearing brain tissue involvement (microglia activation, axonal and neuronal changes)
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