ABSTRACT
Multiple sclerosis (MS) is a chronic, relapsing, and progressive disease of the
central nervous system, which is characterized by heterogeneous patterns of neu-
ropathological damage (1). In some areas of the MS brain, there is perivenular
myelin loss with macrophage and T-cell infiltration; in other areas, there is
more diffuse demyelination; and still other areas, there is damage and death of
oligodendrocytes without remyelination. Later in the disease, glial cell prolifer-
ation becomes predominant. Multiple intermediary metabolic impairments are
present in and around MS lesions, including diminished N-acetyl aspartate and
increased glutaminase activity (2,3). MRI abnormalities of brain and spinal
cord in MS patients consist of both focal and diffuse changes, reflecting the
heterogeneous nature of the underlying molecular alterations in the brain (4).
