Classifying Multiple Sclerosis White Matter Plaques Across the Disease Spectrum

Correlations between pathology and clinical stages of multiple sclerosis (MS) have been unclear. In this study, researchers evaluated a large selection of autopsy tissue blocks to classify the proportion of different plaque types across MS subtypes and durations. Investigators included autopsy material from 120 patients representing all MS subtypes (median age at death, 56; range, 17–86; median disease duration, 12 years; range, 0–48) who contributed 1220 blocks of tissue. Plaques were defined as active (having dense macrophages with myelin products — containing both major and minor myelin proteins in early active plaques and only major proteins in late active plaques), smoldering (having an inactive center surrounded by a rim of activated …