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The "Black Hole" of Multiple Sclerosis

4th August, 2011

Magnetic resonance imaging (MRI) is an important tool for confirming a clinical diagnosis of MS. It is
commonly used today by neurologists to monitor disease progression too.

New areas of active inflammation and demyelination show up as bright spots on scans of the brain and/or spinal cord (Figure 1.) These may disappear after a month or so, when the lesion has healed and symptoms improved. Some plaques however, turn into “black holes” where myelin has been completely lost and nerve cells have been damaged beyond repair (Figure 2).



Why some plaques heal and some do not is still a mystery. But it is clear that the number, size, and location of MS lesions often correlate with a patient’s physical and cognitive disabilities.

To date, most research has focused on analysing MS plaques in the white matter of the brain. They are visible on MRI scans and can be identified with the naked eye on postmortem brain tissue (Figure 3).


There is now, however, increasing evidence that there is a more general problem in the MS brain that may not be related to plaques of demyelination. For example, studies of the normal looking white matter in MS patients indicate that is it not “normal” at all, compared to the white matter of people without MS. This may in part be attributed to disease in the grey matter of MS patients, in particular those with progressive MS, where there is significant tissue damage and general loss in brain volume.Changes in grey matter and normal appearing white matter caused by MS are undetectable using MRI technology. They can only be studied from postmortem tissue donated to brain banks by patients who had MS in their lifetime. These gifts are extremely valuable to research. If you would like to register and help MS research, and join 650 others who have already pledged, please register online or call 1300 672 265 to request a Brain Donor information and consent pack.

Please Note: Being an organ donor does not automatically include brain and spinal tissue donation. A separate consent is needed for medical research.  Remember, we have the brains to cure MS!