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Regional variations in the extent and pattern of grey matter demyelination in Multiple Sclerosis: a comparison between the cerebral cortex, cerebellar cortex, deep grey matter nuclei and the spinal cord
  1. Christopher P Gilmore (chris.gilmore{at}nottingham.ac.uk)
  1. Department of Neurology, Queens Medical Centre Nottingham, United Kingdom
    1. Ian Donaldson (mzyxiad{at}nottingham.ac.uk)
    1. Queens Medical Centre Nottingham, United Kingdom
      1. Lars Bö (lars.bo{at}helse-bergen.no)
      1. National Competence Centre for MS, Department of Neurology, Haukeland University Hospital, Bergen, Norway
        1. Trudy Owens (trudy.owens{at}nottingham.ac.uk)
        1. Department of Economics, University of Nottingham, United Kingdom
          1. J S Lowe (james.lowe{at}nottingham.ac.uk)
          1. Nottingham Univ Medical School, United Kingdom
            1. Nikos Evangelou (nikos.evangelou{at}nuh.nhs.uk)
            1. Department of Neurology, Queens Medical Centre Nottingham, United Kingdom

              Abstract

              Background: Substantial grey matter (GM) demyelination occurs in both the cerebral cortex and the spinal cord in Multiple Sclerosis (MS). GM demyelination also occurs in the cerebellar cortex and the deep GM nuclei of the brain. However no study has made a direct “within-subject” comparison of the extent of GM pathology between these regions.

              Aim: To examine the extent and pattern of GM demyelination in the motor cortex, cingulated gyrus, cerebellum, thalamus and spinal cord in MS.

              Methods: Post-mortem study using material from 14 MS cases and 3 controls. Sections were taken from the 5 predetermined areas and stained for Proteolipid Protein. The extent of GM and WM demyelination was assessed in each region.

              Results and Conclusion: Overall, 28.8% of the GM was demyelinated compared with 15.6% of the WM (p<0.001) with demyelination being greater in the GM than in the WM at each of the anatomical sites. There was substantial variation in the extent of demyelination between different CNS regions. GM demyelination was most extensive in the spinal cord and cerebellum, while WM demyelination was most prominent in spinal cord.

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