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.