A new subtype of multiple sclerosis has been discovered by investigators from the Cleveland Clinic, a discovery that provides insight into the individualized nature of the rare disease.

Demyelination of cerebral white matter has long been considered to be the driver of neuronal degeneration and permanent neurological disability in those with multiple sclerosis (MS). However, now, for the first time, investigators found that the new subtype—referred to as myelocortical MS (MCMS)—features neuronal loss but no demyelination of the brain’s white matter.

For their research, the team of investigators, led by Bruce Trapp, PhD, set to find pathological evidence of cortical neuronal loss independent of cerebral white-matter demyelination by looking at post-mortem brains that belonged to patients with multiple sclerosis.

To do this, Dr. Trapp and his team removed the brain and spinal cords from 100 patients who had died with multiple sclerosis between May 1998 and November 2012. The team conducted their retrospective analysis of the autopsies between September 2011 and February 2018.

For the study, published in the journal Lancet Neurology, they examined centimeter-thick slices of cerebral hemispheres and identified 12 individuals with MCMS, as indicated by demyelinated lesions in the spinal cord and cerebral cortex, but none in the cerebral white matter.

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