In the article, we considered multiple sclerosis not only as an autoimmune and demyelinating pathology, but also as a neurodegenerative disease. We tried to analyze the role of matrix metalloproteinases, in particular matrix metalloproteinase-9 (MMP-9), as an indicator of the activity of the infl ammatory process. The greatest values of MMP-9 were obtained in the group of patients with remitting-recurrent type of fl ow in the stage of exacerbation, unlike the primary-progressive fl ow type at which more manifestations neurodegeneration than infl ammatory. The study allowed to draw conclusions that the determination of the level of MMP-9 is an important biochemical criterion of the activity of the pathological process, the further study of which can provide an opportunity to predict both the development of exacerbation of the disease and the change in the type of the course of multiple sclerosis. Thus, we are able to conduct adequate therapy and possible prospects for further infl uence on neuroprotection and neuroplasticity in neurodegenerative and demyelinating CNS pathologies.