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It also seems that myelin basic protein (MBP) from multiple sclerosis (MS) patients contains lower levels of phosphorylation at Thr97 than normal individuals. [152] NAWM is the place where lesions appear and the process seems to be made by microglia, in absence of leukocyte infiltration, astrogliosis or demyelination.
Most MS findings take place inside the white matter, and lesions appear mainly in a periventricular distribution (clustered around the ventricles of the brain). Apart from white matter demyelination, the cortex and deep gray matter (GM) nuclei can be affected, together with diffuse injury of the NAWM. [ 13 ]
The McDonald criteria states that patients with multiple sclerosis should have lesions which are disseminated in time (DIT) and disseminated in space (DIS), i.e. lesions which have appeared in different areas in the brain and at different times. [88] Below is an abbreviated outline of the 2017 McDonald Criteria for diagnosis of MS.
Among the imaging biomarkers in MS the most known is MRI by two methods, gadolinium contrast and T2-hypertense lesions, but also important are PET and OCT. Among the body fluid biomarkers the most known are oligoclonal bands in CSF but several others are under research. Genetic biomarkers are under study but there is nothing conclusive still.
A new study finds that in about one in 10 cases of multiple sclerosis, the body makes a distinct set of antibodies years before symptoms emerge. (Getty Images) (Md Babul Hosen via Getty Images)
Normally MS lesions are small ovoid lesions, less than 2 cm. long, oriented perpendicular to the long axis of the brain's ventricles [18] Often they are disposed surrounding a vein [19] Demyelinization by MS. The Klüver-Barrera colored tissue show a clear decoloration in the area of the lesion (Original scale 1:100)
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