Multiple sclerosis: an immune or neurodegenerative disorder?

Annu Rev Neurosci. 2008;31:247-69. doi: 10.1146/annurev.neuro.30.051606.094313.


Multiple sclerosis (MS) is an inflammatory-mediated demyelinating disease of the human central nervous system. The clinical disease course is variable, usually starts with reversible episodes of neurological disability in the third or fourth decade of life, and transforms into a disease of continuous and irreversible neurological decline by the sixth or seventh decade. We review data that support neurodegeneration as the major cause of irreversible neurological disability in MS patients. We question whether inflammatory demyelination is primary or secondary in the disease process and discuss the challenges of elucidating the cause of MS and developing therapies that will delay or prevent the irreversible and progressive neurological decline that most MS patients endure.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Axons / immunology
  • Axons / pathology
  • Central Nervous System / immunology*
  • Central Nervous System / physiopathology
  • Disease Progression
  • Encephalitis / immunology*
  • Encephalitis / physiopathology
  • Humans
  • Multiple Sclerosis / immunology*
  • Multiple Sclerosis / physiopathology
  • Myelin Sheath / immunology
  • Myelin Sheath / pathology
  • Neurodegenerative Diseases / immunology*
  • Neurodegenerative Diseases / physiopathology
  • Neuroglia / immunology
  • Neuroglia / metabolism
  • Wallerian Degeneration / immunology
  • Wallerian Degeneration / physiopathology