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Table 1 Key aspects of progressive multiple sclerosis (PMS) distinguishing it from relapsing-remitting multiple sclerosis (RRMS)

From: The link of inflammation and neurodegeneration in progressive multiple sclerosis

- Time to disability progression is not driven by relapse rate, frequency or severity

 

- Fewer active plaques (less inflammation and peripheral immune cell activation and fewer gadolinium enhancing lesions [signifying fewer blood-brain barrier breaches])

 

- Compartmentalised inflammation within the central nervous system (CNS): meningeal inflammatory aggregates (lymphatic follicles-like)

 

- More neurodegeneration: more demyelination and axonal loss in gray matter; more cortical pathology (subpial lesions are almost specific of PMS) and CNS atrophy

 

- More diffuse abnormalities and tissue loss in the normal appearing CNS

 

- Universal progressive spinal cord disease

 

- Anti-inflammatory therapies less effective or ineffective