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For many years, it has been appreciated that multiple sclerosis (MS) pathology is characterized by demyelination of white and gray matter. Whether demyelinating white matter lesions (WMLs) and gray matter lesions (GMLs) represent a distinct type of pathology with a unique origin, or sequential stages in the evolution of a single type of MS, has not yet been resolved. Of interest is that although WMLs and GMLs are characterized by areas of focal demyelination, their histopathological features differ. Besides a lower number of infiltrating leukocytes in GMLs versus WMLs,1,2 less activated microglia, as seen in WMLs, are present in GMLs. This calls into question the role of microglia in cortical gray matter damage in MS.

Much, if not all, of the cortical damage in MS can be attributed to the microglial cell – Yes