Gray-Matter Lesions and Inflammation in MS

Cortical lesions have been shown to be common and extensive among some patients with multiple sclerosis (MS) at autopsy. Prior case series of cortical lesions were based on autopsies of patients with long-standing and often progressive-stage MS, in whom significant cortical-based inflammatory infiltrates were not found. Now, researchers have evaluated brain biopsy specimens from patients who were suspected of having a tumor but were found to have had demyelinating disease instead.

Of 138 patients with early inflammatory demyelinating disease compatible with MS, cortical demyelination was present in 38%. In a subanalysis of 38 patients, T-cell infiltrates were found in most cortical lesions (82%). In 41 patients with cortical demyelination, n…