Demyelination, inflammation, and neurodegeneration in multiple sclerosis deep gray matter.
Gray matter (GM) lesions are recognized as important components of the pathology of multiple sclerosis (MS), and involvement of the deep gray matter (DGM) is suggested by magnetic resonance imaging. The aims of this study were to determine the frequency and distribution of lesions and characterize the inflammatory and neurodegenerative changes in DGM of MS patients. Histochemistry, immunohistochemistry, and morphometry were performed on whole coronal sections of 14 MS and 12 control (6 normal, 6 from amyotrophic lateral sclerosis patients) brains. Demyelinating lesions were frequent in MS DGM; most often in the thalamus and caudate, but they were also seen in the putamen, pallidum, claustrum, amygdala, hypothalamus, and substantia nigra. Most DGM lesions involved both GM and white matter. Inflammation in active DGM lesions was similar to that in lesions only in white matter but was less intense, and there was a preponderance of activated microglia, scarce myelin-laden macrophages, and a lesser extent of axonal damage. Neuronal loss was observed both in DGM lesions and nondemyelinated DGM with neuron atrophy in nondemyelinated DGM. In conclusion, demyelination and neurodegenerative changes are common in MS DGM and may contribute to clinical impairment. Inflammation in DGM lesions is intermediate between the destructive inflammation of white matter lesions and the minimal inflammation of cortical lesions. We hypothesize that alterations of glutamate reuptake mechanisms may contribute to these differences.
Vercellino
Marco
M
Department of Neuroscience, University of Turin, Turin, Italy. vercellino@libero.it
Masera
Silvia
S
Lorenzatti
Marcella
M
Condello
Cecilia
C
Merola
Aristide
A
Mattioda
Alessandra
A
Tribolo
Antonella
A
Capello
Elisabetta
E
Mancardi
Giovanni Luigi
GL
Mutani
Roberto
R
Giordana
Maria Teresa
MT
Cavalla
Paola
P
D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications / Q000473:pathology; D015703:Antigens, CD / Q000378:metabolism; D001921:Brain / Q000473:pathology*; D003711:Demyelinating Diseases / Q000209:etiology* / Q000473:pathology; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006684:HLA-DR Antigens / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000473:pathology*; D004676:Myelin Basic Protein / Q000378:metabolism; D009419:Nerve Tissue Proteins / Q000378:metabolism; D019636:Neurodegenerative Diseases / Q000209:etiology* / Q000473:pathology; D009457:Neuroglia / Q000473:pathology; D009474:Neurons / Q000473:pathology; D013194:Staining and Labeling
D015703:Antigens, CD; D006684:HLA-DR Antigens; D004676:Myelin Basic Protein; D009419:Nerve Tissue Proteins; D005340:Fibrinogen