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MS May Take a Different Pathway Than Previously Thought
Date:12/7/2011

strongly associated with inflammation in the cortex tissue.

About 400,000 Americans have MS, according to the National Multiple Sclerosis Society. Its cause is unknown, but it is believed to occur when the body's immune system chips away at the protective myelin sheath, a fatty insulator that covers nerves, and it can be debilitating. Symptoms can include weakness and numbness, paralysis, poor vision, fatigue, dizziness, and tremor. Its severity varies widely in patients, said Lucchinetti.

Lucchinetti said if scientists can understand the genesis of the disease, better diagnostic procedures and treatments could be developed.

"The findings are provocative," said Dr. Peter Calabresi, professor of neurology and director of the MS Center at Johns Hopkins Hospital, who wrote an accompanying editorial.

"It's an exciting study. For many years we thought MS was predominantly a disease of the white matter. More recently people have found there are some changes in the gray matter. This is the first time that anyone has definitively shown there's extensive inflammation in the gray matter early on in the disease," said Calabresi.

Calabresi likens the findings to leaves on a tree. "Everyone thought the attack was on the leaves, the white matter, but now people think it's more likely the trunk," he said.

Should patients get excited?

Dr. Jerome Graber, an assistant professor of neurology at Albert Einstein College of Medicine in the Bronx, N.Y., said it's a good study, but suggests no immediate clinical benefits. "My answer to my patients is that it doesn't have an immediate implication for them yet. I have no new treatment for you because of this study. But I think it opens a lot of doors for researchers to ask a whole new set of questions," he said. And the link with the meninges is also intriguing, he said.

Calabresi agreed it offers hope. "I think it gives us a lot of hope," he said. "It gives us yet one more tool to follow the
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