Early Indicators Early Treatments Neuroprotection in Multiple Sclerosis

This book reviews the main neurobiological, neurophysiological, MRI and clinical features of the early phases of MS. Mechanisms of irreversible axonal damage and the role played by the interaction between glial and axons are highlighted. Contrary to what was thought for a long time the sufficient availability of oligodendrocyte precursor cells to promote remyelination in acute lesions has now been demonstrated. For not understood reasons, remyelination process fails or does not start in many cases, particularly, in the chronic process of the disease. These findings express the importance of the milieu changes induced by inflammatory process in limiting remyelination. Pathological studies demonstrate that in MS destructive processes may be followed by recovering phases in such a way that myelin may be morphologically and functionally reconstructed. This all brings the rationale of early treatments and the results of clinical trials in early MS to the fore as one of the most important questions today.