Multiple Sclerosis with Reduced Neuronal Densities and Lack of Cerebral Demyelination

Multiple sclerosis (MS) is an autoimmune demyelinating disease characterized by white matter plaques with variable loss of axons. Investigators evaluated the pathologic characteristics of patients who appeared not to have demyelinating white matter lesions at autopsy.

Of 100 patients with MS who underwent autopsy, 12 had no visible white matter lesions on gross inspection of 1 cm slices; these patients were classified as having myelocortical MS (mMS). The mMS cases were matched with 12 individuals with typical MS (tMS), based on visible white matter lesions at autopsy.

The most common clinical phenotype in mMS was secondary progressive MS, but relapsing remitting and primary progressive MS were also represented. Cerebral white matter lesion a…