Massimiliano Calabrese: I'm presenting at ECTRIMS 2024

Speaker: Massimiliano Calabrese, Professor of Neurology, University of Verona

Massimiliano Calabrese: One of the most crucial topics in MS research today is the smouldering inflammation, which seems to be, at least partly, independent of the well known acute inflammation that characterises relapses. Such smouldering inflammation seems responsible for progression independent of relapses and for a large part of the disability accumulation in our patients. The pathogenetic mechanism underlying this part of the disease had only been partially discovered. Still, recent neuropathological MRI data suggest that during each acute event, a certain proportion of the inflammatory cells, when usually restricted to the blood of the lymph nodes, can penetrate within the central nervous system. Some of the cells colonise the meninges going to aggregate in the well known meningeal B-cell follicles. But an important and relevant part of these cells can compartmentalise within the prevascular space around the white matter lesion creating the so called chronic active lesion. These lesions are characterised by a persistent of the chronic low level inflammatory activity that usually is mediated by the microglia activity, and that leads to a poor remyelination and with the time to a progressive and irreversible neuronal and axonal loss that involves not only the white matter but also the cortical and the deep grey matter. Today it is possible to visualise in vivo this lesion using the MRI and specific and nonconventional MRI sequence, and we can detect this lesion and therefore we can try to understand if our disease modifying treatment can be helpful in reducing the activity and the number of these lesions. In my talk at ECTRIMS, I will show you how we can visualise this lesion by MRI in vivo. What we can really detect by MRI, which is the difference between the paramagnetic rim lesion and the slowly expanding lesion. But more importantly, I will show you how this lesion can impact the disability progression in our patient.

Massimiliano Calabrese: ECTRIMS is the most important international conference on MS, the main demyelinating disorder of the central nervous system. An annual meeting that is a point for all MS researchers and clinicians. A moment of discussion and growth that you should not miss. So see you in Copenhagen!