Relapsing and progressive forms of multiple sclerosis: insights from pathology.
OBJECTIVE
The predominant clinical disease course of multiple sclerosis starts with reversible episodes of neurological disability, which transforms into progressive neurological decline. This review provides insight into the pathological differences during relapsing and progressive phases of multiple sclerosis.


RESULTS
The clinical course of multiple sclerosis is variable, and the disease can be classified into relapsing and progressive phases. Pathological studies have been successful in distinguishing between these two forms of the disease and correlate with the clinical findings in terms of cellular responses, the inflammatory environment, and the location of lesions.


CONCLUSIONS
Available therapies for multiple sclerosis patients, while effective during the relapsing phase, have little benefit for progressive multiple sclerosis patients. Development of therapies to benefit progressive multiple sclerosis patients will require a better understanding of the pathogenesis of progressive multiple sclerosis. This review discusses and compares the pathological findings in relapsing and progressive multiple sclerosis patients.
Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Ranjan
R
Dutta
Bruce D
BD
Trapp
D001921:Brain / Q000473:pathology*; D002540:Cerebral Cortex / Q000473:pathology; D018450:Disease Progression; D066128:Gray Matter / Q000473:pathology; D006801:Humans; D020528:Multiple Sclerosis, Chronic Progressive / Q000473:pathology*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000473:pathology*; D066127:White Matter / Q000473:pathology