XVIII.–The Histology of Disseminated Sclerosis

Dawson, Jane

doi:10.1017/s0080456800027174

Cited by 314 publications

(215 citation statements)

References 53 publications

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“…To our knowledge, no in vivo reports are available on central veins in MS lesions located in the spinal cord, although pathological evidence of this phenomenon exists 35 . Another finding from the Kilsdonk et al study was a significantly lower percentage of perivascular deep white matter lesions (73%) in MS patients aged ≥40 years compared with younger patients (92%).…”

Section: The Central Vein In Ms Discussionmentioning

confidence: 99%

The central vein sign and its clinical evaluation for the diagnosis of multiple sclerosis: a consensus statement from the North American Imaging in Multiple Sclerosis Cooperative

et al. 2016

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At present, the diagnosis of multiple sclerosis (MS) relies heavily on the use of MRI, which can demonstrate disease dissemination in space and time [1][2][3][4] . The current 2010 McDonald criteria have enabled earlier diagnosis 5,6 and initiation of disease-modifying treatment, with substantial benefits for disease outcome 7,8 , but they still have imperfect sensitivity and specificity 9,10 . The limited accuracy of the criteria results in challenging cases and misdiagnosis, which are prevalent problems in MS 11,12 . Therefore, more-accurate and pathologically specific MRI criteria are still needed to exclude other disorders that can mimic MS 13,14 .The MRI-detectable central vein inside white matter lesions has recently been proposed as a biomarker of inflammatory demyelination and, thus, may aid the diagnosis of MS 15 . The 'central vein sign' (CVS) has been investigated in various neurological conditions by several groups, and evidence has accumulated that the CVS may have the ability to accurately differentiate MS from its mimics [15][16][17][18][19][20][21] . As a consequence, recent guidelines from the Magnetic Resonance Imaging in MS (MAGNIMS) group 1,4 and the Consortium of MS Centers (CMSC) task force 22 have acknowledged the potential of the CVS and its dedicated MRI acquisitions for the differential diagnosis of MS, while calling for further research before considering a possible modification of the diagnostic criteria. However, the lack of standardization for the definition and imaging of the CVS, as well as a dearth of large-scale prospective studies evaluating the CVS for MS diagnosis, are currently preventing the clinical validation of this potential biomarker 1,23 .This Consensus Statement aims to provide recommendations for the definition, standardization and clinical evaluation of the CVS in the diagnosis of MS. These statements are based on a thorough review of the existing literature on the CVS and the consensus opinion of the members of the North American Imaging in Multiple Sclerosis (NAIMS) Cooperative. E X P E RT C O N S E N S U S D O C U M E N T on behalf of the NAIMS CooperativeAbstract | Over the past few years, MRI has become an indispensable tool for diagnosing multiple sclerosis (MS). However, the current MRI criteria for MS diagnosis have imperfect sensitivity and specificity. The central vein sign (CVS) has recently been proposed as a novel MRI biomarker to improve the accuracy and speed of MS diagnosis. Evidence indicates that the presence of the CVS in individual lesions can accurately differentiate MS from other diseases that mimic this condition. However, the predictive value of the CVS for the development of clinical MS in patients with suspected demyelinating disease is still unknown. Moreover, the lack of standardization for the definition and imaging of the CVS currently limits its clinical implementation and validation. On the basis of a thorough review of the existing literature on the CVS and the consensus opinion of the members of the North American Imaging in Mult...

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Section: The Central Vein In Ms Discussionmentioning

confidence: 99%

The central vein sign and its clinical evaluation for the diagnosis of multiple sclerosis: a consensus statement from the North American Imaging in Multiple Sclerosis Cooperative

et al. 2016

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“…This view was later expanded by Dawson (1916), who described ¢nger-like extensions of pre-existing lesions by sleeve-like demyelination around in£amed vessels that leave the plaques. It was already evident at the turn of the 20th century that the in£ammatory in¢l-trates are mainly composed of small round leucocytes and macrophages (Frommann 1878).…”

Section: Multiple Sclerosis As a Chronic T-cell Mediated Inflammatorymentioning

confidence: 97%

The pathology of multiple sclerosis and its evolution

Lassmann

1999

Phil. Trans. R. Soc. Lond. B

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The pathology of multiple sclerosis (MS) was de¢ned more than a century ago as a chronic in£ammatory process which is associated with widespread primary demyelination and glial scarring. In this short review we discuss controversial issues on (i) the relationship between in£ammation and demyelination, (ii) the various possible mechanisms of myelin destruction, and (iii) axonal involvement in this disease. We suggest that the disease process of MS is more complex that previously believed.

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“…In 1916, in a comprehensive overview of the histology of disseminated sclerosis, James W. 7 , referring to the striking lack of glial proliferation and cellular paucity (an indicator that inflammation was absent) in grey matter lesions. Dawson also wondered: "Is then, the process that attacks the cortex different in its nature and origin from that which affects the rest of the central nervous system?"…”

Section: Introductionmentioning

confidence: 99%

Exploring the origins of grey matter damage in multiple sclerosis

et al. 2015

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Multiple sclerosis is characterized at the gross pathological level by the presence of widespread focal demyelinating lesions of the myelin-rich white matter. However, it is becoming clear that grey matter is not spared, even during the earliest phases of the disease. Furthermore, grey matter damage may have an important role both in physical and cognitive disability. Grey matter pathology involves both inflammatory and neurodegenerative mechanisms, but the relationship between the two is unclear. Histological, immunological and neuroimaging studies have provided new insight in this rapidly expanding field, and form the basis of the most recent hypotheses on the pathogenesis of grey matter damage. DOI: https://doi.org/10.1038/nrn3900Posted at the Zurich Open Repository and Archive, University of Zurich ZORA URL: https://doi.org/10.5167/uzh-111099 Accepted Version Originally published at: Calabrese, Massimiliano; Magliozzi, Roberta; Ciccarelli, Olga; Geurts, Jeroen J G; Reynolds, Richard; Martin, Roland (2015). Exploring the origins of grey matter damage in multiple sclerosis. Nature Reviews Neuroscience, 16 (3) AbstractMultiple sclerosis is characterised at the gross pathological level by the presence of widespread focal demyelinating lesions of the myelin-rich white matter. However, in recent years it has become clear that grey matter is not spared, even during the earliest phases of the disease. Furthermore, grey matter damage has been suggested to have an important role both in physical and cognitive disability. Grey matter pathology involves both inflammatory and neurodegenerative mechanisms, but the relationship between the two is unclear. This review will summarize and highlight important histological, immunological, and neuroimaging results from this rapidly expanding field and will address the most recent hypotheses on the pathogenesis of grey matter damage.

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XVIII.–The Histology of Disseminated Sclerosis

Cited by 314 publications

References 53 publications

The central vein sign and its clinical evaluation for the diagnosis of multiple sclerosis: a consensus statement from the North American Imaging in Multiple Sclerosis Cooperative

The central vein sign and its clinical evaluation for the diagnosis of multiple sclerosis: a consensus statement from the North American Imaging in Multiple Sclerosis Cooperative

The pathology of multiple sclerosis and its evolution

Exploring the origins of grey matter damage in multiple sclerosis

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