This Is MS Multiple Sclerosis Community: Knowledge & Support

Now if they could just figure out why this is happening...



Remyelination is extensive in a subset of multiple sclerosis patients.

Brain. 2006 Aug 18;
Patrikios P, Stadelmann C, Kutzelnigg A, Rauschka H, Schmidbauer M, Laursen H, Sorensen PS, Bruck W, Lucchinetti C, Lassmann H.
Center for Brain Research, Medical University of Vienna, Vienna, Austria.

Although spontaneous remyelination does occur in multiple sclerosis lesions, its extent within the global population with this disease is presently unknown.

We have systematically analysed the incidence and distribution of completely remyelinated lesions (so-called shadow plaques) or partially remyelinated lesions (shadow plaque areas) in 51 autopsies of patients with different clinical courses and disease durations. The extent of remyelination was variable between cases.

In 20% of the patients, the extent of remyelination was extensive with 60-96% of the global lesion area remyelinated. Extensive remyelination was found not only in patients with relapsing multiple sclerosis, but also in a subset of patients with progressive disease. Older age at death and longer disease duration were associated with significantly more remyelinated lesions or lesion areas. No correlation was found between the extent of remyelination and either gender or age at disease onset.

These results suggest that the variable and patient-dependent extent of remyelination must be considered in the design of future clinical trials aimed at promoting CNS repair.

http://www.ncbi.nlm.nih.gov/entrez/quer ... med_docsum

[quote="dignan"]Now if they could just figure out why this is happening...

Remyelination is extensive in a subset of multiple sclerosis patients.


In 20% of the patients, the extent of remyelination was extensive with 60-96% of the global lesion area remyelinated. Extensive remyelination was found not only in patients with relapsing multiple sclerosis, but also in a subset of patients with progressive disease.


I wish there were more information here.

I've always thought that figuring out the whole remyelination mystery would be key to coming up with some way to repair existing damage.

But if the extent of remyelination was variable between patients with different clinical courses... maybe not?

No info on whether the 20% of patients who had extensive remyelination fared better symptomatically than patients who did not - but the bit about extensive remyelination being present in patients with different courses and in a subset of patients with progressive disease makes me think perhaps not.

I guess the up side is that they address the fact that this needs to be looked at when considering trials aimed at promoting CNS repair, but if remyelination makes no difference symptomatically, I wonder what other options they're looking at?


Or am I understanding the abstract incorrectly or reading too much into the sketchy details?

Good question about the implications of these findings for symptoms. I wish I knew the answer. I was thinking of this study as interesting because if they can get to the bottom of why 20% of people see significant remyelination, that could go a long way to coming up with a treatment to stop damage in the first place, even though we're now sure that myelin damage isn't the whole picture with MS.