Med.Sci 532

Structure-Function

Multiple sclerosis (MS) is the most common demyelinating disease afflicting humans.   It is a chronic disease affecting more women than men often leading to progressive neurological deterioration and ataxic paraplegia.  MS has cycles of remission and relapses with remission occurring less frequently as the disease progresses.  Lesions occur in all parts of the CNS white matter appearing gray and translucent.  Some of the more prominent structures affected are the medial longitudinal fasciculus and the optic tract and chiasm.  Damage to the neurons in these structures can lead to optic neuritis (with complete loss of vision in one eye), diplopia (double vision) and problems coordinating eye and head movements.  Onset of the disease is usually between the ages of 20 and 40 years of age.

Histologically there is a large decrease in the number of oligodendrocytes with 90% of the patients having antibodies to these cells.  Many times there is a cuffing of blood vessels due to the high number of lymphocytes, macrophages and plasma cells found in plaques.  Macrophages take a principal role in stripping and phagocytosis of myelin from intact axons.  Efforts to link this autoimmune disease with a virus have been unsuccessful perhaps do to the difficulty of isolating and culturing virus from MS patients.

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