Patients with multiple sclerosis (MS) showed a periventricular gradient of both innate immune cell activation and associated microstructural damage in the white matter (WM); this gradient was higher in clinically worsening patients.
Why this matters
In MS, irreversible central nervous system injury leads to disability worsening.
Prior evidence suggested that proximity to cerebrospinal fluid (CSF), and potentially CSF-derived pro-inflammatory cytokines, predisposes to cortical damage, leading to a periventricular gradient of microstructural damage.
Through studying the biological mechanism underlying the relationship between CSF proximity and tissue injury in vivo, disability worsening in MS can be explained and targeted.
Post-mortem evidence indicated an involvement of activated microglial cells.