Progress of myelination in the human fetal spinal nerve roots, spinal cord and brainstem with myelin basic protein immunohistochemistry

The early progress of myelination was studied, by means of myelin basic protein (MBP) immunohistochemistry and luxol-fast-blue (LFB) staining, in the spinal cord, spinal nerve roots and brainstem of 66 fetuses and neonates. The degree of myelination was classified from 1 (slight) to 4 (mature). MBP immunoreactivity exhibited slight LFB positivity. Myelination first occurred in the medial longitudinal fasciculus at 20 weeks of age, reaching degree 4 at 34 weeks, but began at 23-24 weeks in the other sites. Myelination of spinal nerve roots progressed with gestation and attained degree 4 at 35-36 weeks. The cuneate fasciculus also reached degree 4 at 34-36 weeks, but corticospinal tracts and solitary tracts, which exhibited long myelinating phases, were slow and incomplete at 40 weeks. This normal development of MBP and LFB myelination can be used for the assessment of delayed myelination in fetal and neonatal diseases.