NEW ORLEANS—Despiteaconsensusthattherepair capacity of the adult human brain decreases with
age, cortical remyelination appears to continue in patients
with multiple sclerosis (MS) into the eighth decade of
life, according to research presented at the 2013 Annual
Meeting of the American Neurological Association.
Depending on the region of the brain, the environment
may affect remyelination, said Bruce Trapp, PhD, Chair
of the Department of Neurosciences at the Lerner Research
Institute of the Cleveland Clinic. Sulfate proteoglycans
inhibit the differentiation of oligodendrocyte progenitor
cells (OPCs) and are highly expressed in chronic
white-matter lesions, but not in gray-matter lesions.
These findings have “therapeutic implications
because we’re at the cusp of designing clinical trials for
remyelinating therapies,” said Dr. Trapp. “Therapeutic
enhancement of white-matter remyelination may be
more efficacious for acute lesions in early stages of MS.
Cortical remyelination should be considered as a primary
outcome measure in clinical trials that test remyelin-
ation because it may be a more amenable target for
enhancement,” he added.
Oligodendrocytes Were More Common in Gray Matter
Cortical lesions are not inflamed to the same extent as
white-matter lesions and consequently are difficult to
detect by standard MRI techniques in living patients.
Remyelination May Continue Despite
Age in Patients With MS
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