Why are multiple sclerosis plaques found in the white matter of the central nervous system?

Multiple sclerosis (MS) is a demyelinating disease characterized by the destruction of the myelin sheath that surrounds nerve fibers. In the context of pathology, the plaques associated with MS are found in the white matter of the central nervous system because this region is rich in the myelinated axons that the immune system mistakenly targets.12

While the exact cause of this autoimmune response remains unknown, the pathology involves infiltrating lymphocytes and macrophages that exacerbate the destruction of myelin. These scattered areas of inflammation, known as plaques, represent the sites where the protective myelin has been damaged, leading to the progressive degeneration of nerve function. Although researchers have suggested that genetic susceptibility and potential environmental or viral triggers may play a role in initiating this process, the specific reason why the immune system targets these white matter structures remains a subject of ongoing study.12