From: The link of inflammation and neurodegeneration in progressive multiple sclerosis
- Time to disability progression is not driven by relapse rate, frequency or severity | |
- Fewer active plaques (less inflammation and peripheral immune cell activation and fewer gadolinium enhancing lesions [signifying fewer blood-brain barrier breaches]) | |
- Compartmentalised inflammation within the central nervous system (CNS): meningeal inflammatory aggregates (lymphatic follicles-like) | |
- More neurodegeneration: more demyelination and axonal loss in gray matter; more cortical pathology (subpial lesions are almost specific of PMS) and CNS atrophy | |
- More diffuse abnormalities and tissue loss in the normal appearing CNS | |
- Universal progressive spinal cord disease | |
- Anti-inflammatory therapies less effective or ineffective |