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Concentric sclerosis (Baló): Morphometric and in situ hybridization study of lesions in six patients
Author(s) -
Yao DaLin,
Webster Henry deF.,
Hudson Lynn D.,
Brenner Michael,
Liu DuoSan,
Escobar Alfonso I.,
Komoly Samuel
Publication year - 1994
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410350105
Subject(s) - white matter , multiple sclerosis , remyelination , pathology , myelin , in situ hybridization , lesion , luxol fast blue stain , central nervous system disease , immunocytochemistry , biology , medicine , anatomy , central nervous system , magnetic resonance imaging , neuroscience , messenger rna , immunology , radiology , biochemistry , gene
Brain tissues from 6 patients with concentric sclerosis (Baló) were examined by in situ hybridization, immunocytochemistry, morphometry, and histological methods. The patients were 24 to 48 years old and had progressive cerebral symptoms and signs that lasted 15 to 100 days. Large demyelinative lesions, most frequent in the frontal white matter, contained alternating bands of demyelinated and partly myelinated white matter that were arranged in concentric or mosaic patterns. In the areas of demyelination, axons were relatively well preserved and there were perivascular inflammatory infiltrates. In 2 specimens, lesions contained regions with the characteristic appearance of actively demyelinating multiple sclerosis plaques. Oligodendroglial densities were highest in normal‐appearing white matter, lower in partially myelinated areas, and lowest in demyelinated areas, which also contained many hypertrophic astrocytes closely associated with oligodendroglia. Messenger RNA levels for myelin‐related proteins followed the same pattern; they were lowest in demyelinated areas, higher in partially myelinated areas, and highest in normal‐appearing white matter beyond lesion margins. Our findings suggest that concentric sclerosis is a variant of multiple sclerosis, that oligodendroglial loss is important in the pathogenesis of demyelination, and that partially myelinated areas probably represent stages of ongoing myelin breakdown rather than remyelination of previously demyelinated areas.