2021 Volume 38 Issue 4 Pages 547-550
The hallmark of early multiple sclerosis (MS) pathology is “inflammatory demyelination”, whereas neurodegeneration leading to brain atrophy begins unexpectedly early in the course, at least subclinically. Oxidative stress caused by inflammation and remyelination failure are two major mechanisms underlying neurodegeneration, while B cells and neuroinflammation as well as aging process may also contribute during the progressive phase. For the brain health of MS, early diagnosis and adequate treatment from the beginning of disease course is mandatory. After “MS domino” started to run, its pathology becomes far more complicated and multimodal approach may be necessary to halt the disease progression.