Evidence of Axonal Damage in the Early Stages of Multiple Sclerosis and Its Relevance to Disability

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Abstract
THE IMPORTANCE of axonal injury in multiple sclerosis (MS) is being increasingly appreciated.1-4 Neuropathologic techniques have demonstrated that sparing of axons is only relative in MS.5,6 Pathologic evidence of injured or transected axons is common in active MS lesions, and chronic lesions show clear evidence of axonal injury.6,7 Although there is increasing agreement that axonal loss is a major factor contributing to disability in the later stages of MS,7-9 the relation of axonal damage to disability in the early stages of MS is less clear.