Contributions
Abstract: P924
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Pathology
Methods: Two hundred thirty six MS cases (4500 tissue blocks) were included. Lesion types were scored according to demyelination, microglia morphology and anatomical location. Reactive, active, chronic active, chronic inactive and shadow plaques were distinguished in white matter and demyelination in grey matter lesions. Inflammatory activity of lesions was scored based on three types of microglia morphology based on size and ramifications. The proportion of lesion types was inferred from indexes (relative presence). Analysis was performed on total lesion load and indexes in relation to clinical characteristics and gender.
Results: We found large heterogeneity of lesion load, lesion activity, lesion location and remyelination between patients but not within a patient. Total white matter lesion load correlated positively with disease severity (p=7x10-7). The active lesion index correlated positively with disease severity (R^2: 0.14 p=1.9e-06), the reactive site index (p=0.018) and the foamy microglia morphology index (p=0.00029). More males had cortical grey matter lesions (p = 0.004). The presence of cortical grey matter lesions was predicted by disease severity (p=0.006) and sex (p=0.016), while grey matter lesion incidence was significantly reduced in females with a mild clinical course of MS. The chronic active lesion index was higher in males than in females (p=0.04).
Interpretation: The large heterogeneity in MS neuropathology between patients observed is related to heterogeneity in clinical disease course of these patients. More severe MS was characterized by a higher total lesion load, presence of cortical grey matter lesions and a higher proportion of active lesions. Importantly, sex differences are present in the neuropathology of MS; males show more grey matter lesions and a higher proportion of chronic active lesions. This heterogeneity of MS pathology with gender as an important factor, is in line with the known clinical and radiological heterogeneity and gender differences in MS.
Disclosure: I. Huitinga; nothing to declare
M. Mason: nothing to declare
N. Fransen: nothing to declare
C. van Eden: nothing to declare
S. Luchetti: nothing to declare
Abstract: P924
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Pathology
Methods: Two hundred thirty six MS cases (4500 tissue blocks) were included. Lesion types were scored according to demyelination, microglia morphology and anatomical location. Reactive, active, chronic active, chronic inactive and shadow plaques were distinguished in white matter and demyelination in grey matter lesions. Inflammatory activity of lesions was scored based on three types of microglia morphology based on size and ramifications. The proportion of lesion types was inferred from indexes (relative presence). Analysis was performed on total lesion load and indexes in relation to clinical characteristics and gender.
Results: We found large heterogeneity of lesion load, lesion activity, lesion location and remyelination between patients but not within a patient. Total white matter lesion load correlated positively with disease severity (p=7x10-7). The active lesion index correlated positively with disease severity (R^2: 0.14 p=1.9e-06), the reactive site index (p=0.018) and the foamy microglia morphology index (p=0.00029). More males had cortical grey matter lesions (p = 0.004). The presence of cortical grey matter lesions was predicted by disease severity (p=0.006) and sex (p=0.016), while grey matter lesion incidence was significantly reduced in females with a mild clinical course of MS. The chronic active lesion index was higher in males than in females (p=0.04).
Interpretation: The large heterogeneity in MS neuropathology between patients observed is related to heterogeneity in clinical disease course of these patients. More severe MS was characterized by a higher total lesion load, presence of cortical grey matter lesions and a higher proportion of active lesions. Importantly, sex differences are present in the neuropathology of MS; males show more grey matter lesions and a higher proportion of chronic active lesions. This heterogeneity of MS pathology with gender as an important factor, is in line with the known clinical and radiological heterogeneity and gender differences in MS.
Disclosure: I. Huitinga; nothing to declare
M. Mason: nothing to declare
N. Fransen: nothing to declare
C. van Eden: nothing to declare
S. Luchetti: nothing to declare