Heterogeneity in Multiple Sclerosis: Scratching the Surface of a Complex Disease

Table 4

Patterns of demyelination described by Lucchinettiet al. 2000 [7].

Pattern of white matter demyelination	Pathology
(i) Macrophage mediated	(i) Perivenous distribution of lesions
	(ii) T cell and macrophage infiltrates
	(iii) Shadow plaques (remyelination)
	(iv) Sharp lesion edges
(ii) Antibody mediated	(i) As pattern I lesions
	(ii) Deposition of immunoglobulin and activated complement
(iii) Distal oligodendrogliopathy	(i) Important oligodendrocyte apoptosis
	(ii) T cell, macrophage, and microglia infiltrates
	(iii) Degeneration of distal oligodendrocyte processes
	(iv) Ill defined lesion edges
	(v) Preferential loss of myelin associated glyco-protein (MAG)
	(vi) Concentric Balo-like lesions
(iv) Primary oligodendrocyte damage	(i) Similar to pattern I
	(ii) Massive oligodendrocyte loss