Arnold Douglas L
Montreal Neurological Institute and Dept. of Neurology and Neurosurgery, McGill University, 301 University St., Montreal, Quebec, Canada H3A 2B4.
J Neurol. 2005 Nov;252 Suppl 5:v25-9. doi: 10.1007/s00415-005-5005-4.
Multiple sclerosis has long been recognized as a multifocal inflammatory demyelinating disease of the central nervous system. The fact that patients with multiple sclerosis can develop a secondary progressive phase of their disease which is resistant to anti-inflammatory therapies, together with the fact that brain atrophy can develop in patients with a relatively low volume of white matter lesions, has led to suggestions that multiple sclerosis may be a degenerative disease. However, primary degenerative disorders are not usually associated with recurrent episodes of inflammatory demyelination. Support for neurodegeneration in MS being associated with focal lesions comes from topographical mapping of the spatial relationship of axonal injury and tissue loss to lesions using advanced image analysis methods.
长期以来，多发性硬化症一直被认为是一种中枢神经系统的多灶性炎性脱髓鞘疾病。多发性硬化症患者会发展出对抗炎治疗有抗性的疾病继发性进展期，以及在白质病变体积相对较小的患者中会出现脑萎缩，这些事实使人认为多发性硬化症可能是一种退行性疾病。然而，原发性退行性疾病通常与炎性脱髓鞘的反复发作无关。支持多发性硬化症中的神经退行性变与局灶性病变相关的证据来自于使用先进图像分析方法对轴突损伤和组织损失与病变的空间关系进行的地形学绘图。
