Progressive axonal loss is the most likely pathologic correlate of irreversible neurologic impairment in primary progressive multiple sclerosis. In a run-in versus treatment trial, we show that the neuroprotective agent riluzole seems to reduce the rate of cervical cord atrophy and the development of hypointense T1 brain lesions on magnetic resonance imaging.
Ferguson B , Matyszak MK , Esiri MM , Perry VH.Axonal damage in acute multiple sclerosis lesions . Brain1997; 120(Pt 3): 393-399 .
2.
Trapp BD , Peterson J , Ransohoff RM , Rudick R , Mork S , Bo L.Axonal transection in the lesions of multiple sclerosis . N Engl J Med1998; 338: 278-285 .
3.
Scolding N , Franklin R.Axon loss in multiple sclerosis . Lancet1998; 352: 340-341 .
4.
van Waesberghe JH , Kamphorst W , De Groot CJ , et al.Axonal loss in multiple sclerosis lesions: magnetic resonance imaging insights into substrates of disability . Ann Neurol1999; 46: 747-754 .
5.
Pitt D , Werner P , Raine CS.Glutamate excitotoxicity in a model of multiple sclerosis . Nat Med2000; 6: 67-70 .
6.
Werner P , Pitt D , Raine CS.Multiple sclerosis: altered glutamate homeostasis in lesions correlates with oligodendrocyte and axonal damage . Ann Neurol2001; 50: 169-180 .
7.
Bensimon G , Lacomblez L , Meininger V , ALS/Riluzole Study Group . A controlled trial of riluzole in amyotrophic lateral sclerosis . N Engl J Med1994; 330: 585-591 .
8.
Stevenson VL , Leary SM , Losseff NA , et al.Spinal cord atrophy and disability in MS: a longitudinal study . Neurology1998; 51: 234-238 .
9.
Coles AJ , Wing MG , Molyneux P , et al.Monoclonal antibody treatment exposes three mechanisms underlying the clinical course of multiple sclerosis . Ann Neurol1999; 46: 296-304 .
