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Chronic Axonal Injury

Posted: Fri Dec 09, 2011 2:40 pm
by Karazhan
Is anyone familiar with this term?

I recently had my 2nd MRI (almost 3 years since the first) and I'd like to know what chronic axonal injury could indicate. To put it in context, here's the sentence: "The right periventricular lesion is associated with T1 hypointensity, which in multiple sclerosis could be a sign of chronic axonal injury".
I used a very helpful MRI guide to help me understand the rest of the report, I think someone on this forum had linked it, but I've never seen this particular term before. I appreciate any thoughts you might have.
Kara

Re: Chronic Axonal Injury

Posted: Fri Dec 09, 2011 11:18 pm
by jackD
This may NOT cheer you up. But here it is...

jackD


N Engl J Med. 1998 Jan 29;338(5):278-85.

Axonal transection in the lesions of multiple sclerosis.

Trapp BD, Peterson J, Ransohoff RM, Rudick R, Mörk S, Bö L.

SourceDepartment of Neurosciences, Lerner Research Institute, Cleveland Clinic Foundation, OH 44195, USA.

Abstract
BACKGROUND: Multiple sclerosis is an inflammatory demyelinating disease of the central nervous system and is the most common cause of neurologic disability in young adults. Despite antiinflammatory or immunosuppressive therapy, most patients have progressive neurologic deterioration that may reflect axonal loss. We conducted pathological studies of brain tissues to define the changes in axons in patients with multiple sclerosis.

METHODS: Brain tissue was obtained at autopsy from 11 patients with multiple sclerosis and 4 subjects without brain disease. Fourteen active multiple-sclerosis lesions, 33 chronic active lesions, and samples of normal-appearing white matter were examined for demyelination, inflammation, and axonal pathologic changes by immunohistochemistry and confocal microscopy. Axonal transection, identified by the presence of terminal axonal ovoids, was detected in all 47 lesions and quantified in 18 lesions.

RESULTS: Transected axons were a consistent feature of the lesions of multiple sclerosis, and their frequency was related to the degree of inflammation within the lesion. The number of transected axons per cubic millimeter of tissue averaged 11,236 in active lesions, 3138 at the hypocellular edges of chronic active lesions, 875 in the hypocellular centers of chronic active lesions, and less than 1 in normal-appearing white matter from the control brains.

CONCLUSIONS: Transected axons are common in the lesions of multiple sclerosis, and axonal transection may be the pathologic correlate of the irreversible neurologic impairment in this disease.

Comment in
N Engl J Med. 1998 Jan 29;338(5):323-5.
PMID:9445407[PubMed - indexed for MEDLINE]