REMYELINATION EXTENSIVE IN SUBSET OF THOSE WITH MS
A study by an international team of collaborators suggests that a substantial amount of natural remyelination can occur in people with MS. While previous studies had shown natural myelin repair in people with MS, this study found evidence of extensive myelin repair - not only in patients with relapsing MS, but also in a subset of patients with progressive disease.

The investigators examined completely remyelinated lesions (so-called shadow plaques) or partially remyelinated lesions (shadow plaque areas) in 51 autopsies of patients with different clinical courses and disease durations.

In about 20 percent of patients' brains studied, remyelination was extensive, not only in those with a relapsing course, but also in those with progressive disease. The extent of remyelination was variable. In 20% of the patients, the extent of remyelination was extensive, with 60-96% of the global lesion area remyelinated. Longer disease duration and older age at death were associated with more extensive remyelination. No link was found between the extent of repair and the age at onset, gender or type of MS.

Further research is needed to determine why some individuals show highly efficient myelin repair while others do not. These study results indicate that the variable and individual extent of remyelination must be considered in the design of future clinical trials seeking to promote CNS repair.

Center for Brain Research, Medical University of Vienna, Vienna, Austria