Multiple sclerosis (MS) is an inflammatory demyelinating disorder of the central nervous system characterized by progressive neurodegeneration. Current management aims to reduce the inflammation through immunomodulation. However, the effectiveness of these treatments for preventing degeneration is unclear. Vascular alterations, which may be caused by inflammatory cerebral endotheliopathy,1 could play a role in neurodegeneration. Indeed, increased incidence of ischemic stroke and diffuse hypoperfusion in normal-appearing white and gray matter have been reported in MS patients.
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