Pathology and Pathogenesis of Progressive Multiple Sclerosis: Concepts and Controversies

Adrian-Minh Schumacher; Christoph Mahler; Martin Kerschensteiner

doi:10.1055/s-0043-106704

Neurology International Open, Table of Contents

Neurology International Open 2017; 01(03): E171-E181
DOI: 10.1055/s-0043-106704

Review

Pathology and Pathogenesis of Progressive Multiple Sclerosis: Concepts and Controversies

Adrian-Minh Schumacher^*

¹Institute of Clinical Neuroimmunology, Biomedical Center and University Hospital, Ludwig-Maximilians Universität München, Munich, Germany

,

Christoph Mahler^*

¹Institute of Clinical Neuroimmunology, Biomedical Center and University Hospital, Ludwig-Maximilians Universität München, Munich, Germany

,

Martin Kerschensteiner

¹Institute of Clinical Neuroimmunology, Biomedical Center and University Hospital, Ludwig-Maximilians Universität München, Munich, Germany

› Author Affiliations

Abstract

Multiple sclerosis (MS) is an inflammatory disease of the central nervous system that initially is often dominated by relapsing-remitting neurological symptoms. With increasing disease duration these relapses are more and more superimposed by a progressive disease process that leads to an irreversible accumulation of motor, sensory and cognitive deficits. This progressive phase of MS is still only incompletely understood and by and large refractory to therapy. Here we aim to use recent pathological and pathomechanistic insights to outline a unifying concept of progressive MS. Based on this view of the disease we examine current controversies surrounding progressive MS. We discuss whether neurodegenerative or inflammatory processes drive progression, question whether the classification of primary and secondary progressive MS is all that useful and deliberate, which therapeutic strategies are best suited to limit the insidious neurological decline of progressive MS patients.

Key words

multiple sclerosis - white matter pathology - grey matter pathology - chronic inflammation - neurodegeneration

Full Text

References

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