The pathology of multiple sclerosis: a historical perspective

Abstract

In the century and a half since multiple sclerosis (MS) was first recognized, the pathology of the condition has been defined with increasing detail. From the recognition and definition of MS as a clinical phenomenon, studies of the diseased brain tissue have progressed in a manner dependent on the science of the time. Through multiple generations, the increasingly detailed analysis of the MS lesion itself has lead to an increasingly sophisticated understanding of a complex, apparently diverse, immunopathological process. During this evolution, many hypotheses concerning the pathogenesis of MS have been overturned, and the interpretation of some clearly delineated gross and histological findings have been reversed. This review plots the progress and highlights current theories and emerging concepts regarding one of the most enigmatic of neurological diseases.