A new study suggests demyelination may not be as good an indicator of disease progression in multiple sclerosis as previously thought. The authors said trying to detect demyelinating lesions in the cortex may be less important than measuring the density of neurons in the brain and starting early active treatment.
 
Researchers from Queen Mary University of London dissected and analyzed brains from nine people with MS and seven healthy controls. They found that the number of neurons was 14.9 billion in MS versus 24.4 billion in controls – a 39 percent difference. The density of neurons in MS was smaller by 28 percent, and cortical volume by 26 percent, and they found that the whole brain was affected equally.
 
Importantly, the number of neurons was strongly linked with the thickness of the cortex, which can be measured by MRI. The decline in volume of the cortex could therefore be detected in vivo and be used to predict neuronal loss in patients or measure neurodegeneration during clinical trials.
 
Because the loss of neurons is responsible for cognitive and other functions, which occurs early in MS, the researchers said early treatment is key to avoiding neurodegeneration.
 
The findings were published in the journal Neuropathology and Applied Neurobiology.