Multiple sclerosis: mechanisms of neurodegeneration. Instrumental markers of neurodegeneration (literature review)

Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system associated with demyelination. It has been proven that neurodegeneration processes play a key role in the disability of patients. Instrumental possibilities for detecting neurodegeneration in MS include magnetic resonance imaging (MRI), optical coherence tomography of the retina and evoked potentials. The signs of neurodegeneration on MRI include the detection of hypointensive T1 and hyperintensive T2 lesions, T1/T2 ratio, the appearance of metal deposition as “iron rims” (IRl), an increase in the size of the lateral ventricles and a decrease in cerebral parenchyma with MR morphometry. The central vein symptom (CVS) and leptomeningeal contrast enhancement are studied as differential diagnostic signs. With positron emission tomography (PET) it is possible to identify foci of microglia activation as a future localization of neurodegeneration. Early detection of markers of neurodegeneration permits to predict the severity of the course of MS, monitor the effectiveness of treatments, the transition of the remitting form of MS to the progressive form and promptly change the MS modifying therapies.

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