The pathology of multiple sclerosis

Multiple sclerosis (MS) is a chronic neurologic disease affecting approximately I million adults worldwide. Relapses and progression are the two basic clinical phenomena of prototypic MS. Relapses are the clinical expression of acute focal or multifocal inflammatory demyelination disseminated in the central nervous system, whereas progression reflects the occurrence of chronic demyelination, axonal loss, and gliosis. Early in the disease, remission of symptoms likely is the result of remyelination and resolution of inflammation, but after recurrent attacks, remyelination is limited. Inflammatory and noninflammatory factors likely contribute to short- and long-term disability in MS. This review highlights recent advances in experimental neuropathology that have contributed to a better understanding of MS lesion pathogenesis.