Cortical Lesions in Multiple Sclerosis and Inflammatory Cytokines in CSF

Patients with multiple sclerosis (MS) are more likely to have early onset aggressive disease if they have grey matter damage and meningeal demyelination. Whether these changes can be identified by markers in cerebrospinal fluid (CSF), especially early in the disease course, is unknown.

To find out, investigators tested postmortem samples from 27 patients with progressive MS and identified patients with either low or high densities of meningeal inflammation. Those with high meningeal inflammation had frequent aggregates of CD20+ B cells and CD3+ T cells in the subarachnoid space. Patients with high meningeal inflammation had worse disability (earlier age of wheelchair use and death) than the low-inflammation group. Gene expression for several…