Steven E. Schutzer SE et al. Gray Matter Is Targeted in First-Attack Multiple Sclerosis 10 Sep 2013 | PLOS ONE10.1371/journal.pone.0066117
The cause of multiple sclerosis (MS), its driving pathogenesis at the earliest stages, and what factors allow the first clinical attack to manifest remain unknown. Some imaging studies suggest gray rather than white matter may be involved early, and some postulate this may be predictive of developing MS. Other imaging studies are in conflict. To determine if there was objective molecular evidence of gray matter involvement in early MS we used high-resolution mass spectrometry to identify proteins in the cerebrospinal fluid (CSF) of first-attack MS patients (two independent groups) compared to established relapsing remitting (RR) MS and controls. We found that the CSF proteins in first-attack patients were differentially enriched for gray matter components (axon, neuron, synapse). Myelin components did not distinguish these groups. The results support that gray matter dysfunction is involved early in MS, and also may be integral for the initial clinical presentation.
This study looked at spinal fluid from MSers and from people with the first episode. They identified 2,820 proteins in MS CSF, compared to 2,586 proteins in normal CSF and 3,587 proteins in CSF of other neurological disease. There were 1,337 proteins unique to MS CSF, 633 proteins unique to healthy normal CSF
When they looked at the proteins they found a lot of proteins that suggest damage to the nerves and the grey matter. Therefore they make the suggestion that the Grey Matter is the early target rather than the white matter. MRI imaging has already shown that there are Grey matter changes early in MS and this study may support that view. Maybe by looking at the signature of the spinal fluid,it may help with diagnosis, as to treatments stemming from the work is sometime away. However it does suggest that some brain shredding is occurring rapidly after diagnosis. Nerve damage is perhaps more important than demyelination,