Give Online: Help shape patient care for generations to come.
Cleveland Clinic Logo

Cleveland Clinic Researchers Find Targeting Gray Matter More Effective in Delaying Progression of Multiple Sclerosis

Researchers Report Robust Replacement of Cells in Patients with Multiple Sclerosis

October 18, 2012

Regardless of age, the cerebral cortex retains the ability to produce cells that replace damaged myelin, according to researchers at Cleveland Clinic’s Lerner Research Institute. These studies suggest that the cortex—or gray matter—may be a better location for testing new therapies designed to enhance remyelination in multiple sclerosis (MS).

Multiple sclerosis has long been viewed as a disease of the brain’s white matter, where immune cells destroy the myelin or insulation that surrounds the fibers that connect nerve cells.  In early stages of the disease, the white matter can produce new cells that replace the destroyed myelin. As MS patients age, however, this repair capacity is lost. 

“We know that the brains of MS patients can repair lesions in the white matter, but this repair process fails with age,” said Bruce Trapp, PhD, Chairman of Neurosciences at Cleveland Clinic. “What we found is that gray matter lesions continuously replace myelin, regardless of the patient’s age.”

Understanding the mechanisms of successful or unsuccessful remyelination can lead to new therapies, which will increase myelin repair and delay the progression of disability in patients with this disease.

In a study, recently published online in The Annals of Neurology, researchers at Cleveland Clinic’s Lerner Research Institute studied postmortem brain tissue in 22 patients (aged 27-77) with MS and examined lesions in white and gray matter. Their findings showed a generation of brain cells that produced  myelin was greater in gray matter lesions. The remyelination in gray matter occurred regardless of disease duration or patient age.  Lastly, they found the white matter had more reactive molecules that are known to inhibit remyelination.

In the United States today, there are approximately 400,000 people with multiple sclerosis—with 200 more people diagnosed every week. Worldwide, MS is thought to affect more than 2.1 million people, according to the National Multiple Sclerosis Society.  MS is a chronic, unpredictable disease of the central nervous system (the brain, optic nerves and spinal cord). It is thought to be an autoimmune disorder. This means the immune system incorrectly attacks a person’s healthy tissue.

This work was supported by The National Institute of Health, The National Institute of Neurological Disorders and Stroke and The National Multiple Sclerosis Society.

Dr. Trapp’s research won the MS Society’s 2009 Stephen C. Reingold Award, as the highest ranked research proposal.

About Cleveland Clinic

Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S.News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. About 2,800 full-time salaried physicians and researchers and 11,000 nurses represent 120 medical specialties and subspecialties. Cleveland Clinic Health System includes a main campus near downtown Cleveland, eight community hospitals and 18 Family Health Centers in Northeast Ohio, Cleveland Clinic Florida, the Lou Ruvo Center for Brain Health in Las Vegas, Cleveland Clinic Canada, and opening in 2013, Cleveland Clinic Abu Dhabi. In 2010, there were 4 million visits throughout the Cleveland Clinic health system and 167,000 hospital admissions. Patients came for treatment from every state and from more than 100 countries. Visit us at  Follow us at

About the Lerner Research Institute

The Lerner Research Institute is home to Cleveland Clinic’s laboratory, translational and clinical research. Its mission is to promote human health by investigating in the laboratory and the clinic the causes of disease and discovering novel approaches to prevention and treatments; to train the next generation of biomedical researchers; and to foster productive collaborations with those providing clinical care. The total annual research expenditure approached $250 million in 2011 (including more than $110 million in federal funding). More than 2,000 people (including approximately 250 principal investigators, nearly 250 postdoctoral fellows, and almost 200 graduate students) in 13 departments work in research programs focusing on cardiovascular, cancer, neurologic, musculoskeletal, allergic and immunologic, eye, metabolic, and infectious diseases. The Institute includes more than 700,000 square feet of space. Institute faculty oversee the curriculum and teach students enrolled in the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University – training the next generation of physician-scientists, and they participate in multiple doctoral programs, including a new Molecular Medicine PhD Program supported in part by the Howard Hughes Medical Institute.

Media Contact:

Halle Bishop Weston, 216.445.8592,
Tracy Wheeler, 216-444-4235,