title: Lack of correlation between cortical demyelination and white matter pathologic changes in multiple sclerosis.
abstract: BACKGROUND
  Histopathologic studies have shown that subpial cortical demyelination is extensive in chronic multiple sclerosis (MS).
  
  
  OBJECTIVE
  To study whether subpial cortical demyelination in MS is associated with focal or diffuse white matter (WM) pathologic features on magnetic resonance imaging (MR imaging).
  
  
  METHODS
  Comparison of postmortem MR imaging findings with histopathologic findings.
  
  
  METHODS
  Brain donations from a general community.
  
  
  METHODS
  Three patients with MS with extensive cortical demyelination and 3 patients with minor cortical demyelination were selected from an MS autopsy data set. The postmortem MR imaging and histopathologic data of the patients were compared.
  
  
  METHODS
  Two observers blinded to the results of each other assessed the presence, extent, and distribution of focal and diffuse pathologic changes in WM by MR imaging and by histopathology.
  
  
  RESULTS
  Extensive subpial demyelination was not associated with a significant increase in the area of focal and diffuse WM pathologic changes as assessed by Luxol fast blue histochemistry or by MR imaging or with the presence or extent of juxtacortical abnormalities on MR imaging.
  
  
  CONCLUSIONS
  The lack of association of MS gray matter demyelination with diffuse or focal WM changes indicates that gray matter demyelination in MS occurs largely independent of WM pathologic changes. The extent or distribution of WM abnormalities cannot be used to identify extensive cortical demyelination in the clinical setting.
authors.affiliation: Department of Pathology, MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands. l.boe@vumc.nl
authors.forename: Lars
authors.initials: L
authors.lastname: Bö
authors.forename: Jeroen J G
authors.initials: JJ
authors.lastname: Geurts
authors.forename: Paul
authors.initials: P
authors.lastname: van der Valk
authors.forename: Chris
authors.initials: C
authors.lastname: Polman
authors.forename: Frederik
authors.initials: F
authors.lastname: Barkhof
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy / Q000379:methods; D002540:Cerebral Cortex / Q000378:metabolism / Q000473:pathology*; D003711:Demyelinating Diseases / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D004676:Myelin Basic Protein / Q000378:metabolism; D011180:Postmortem Changes; D018709:Statistics, Nonparametric
chemical_list: D004676:Myelin Basic Protein