Neuropathology

The typical histopathological lesion of MS is the demyelinating plaque from which the alternative name sclerose en plaques derives. It is well established that plaques are present not only in the white matter of the brain, cerebellum, brainstem and spinal cord, but also in the gray matter. The introduction of double inversion recovery MRI sequences has made possible to show that cortical lesions are consistently present, not only in patients with a progressive disease but also in patients with CIS and RR MS. Several classifications of the plaques based on the activity level of pathological processes, disease stage and supposed pathogenetic processes have been proposed.