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Understanding Tissue Damage

Understanding the processes that lead to tissue damage in MS is crucial to our focus on reversing this damage to regain function through nervous system and myelin repair.


In this article


We pursue all promising paths to uncover solutions for EVERYONE with MS, wherever those opportunities exist, while focusing on three priority areas, including progressive MS – bringing answers and solutions where none exist today; and nervous system repair – reversing damage to regain function through nervous system and myelin repair.

Understanding the processes that lead to tissue damage in MS is crucial to these priorities. The immune attack in MS unleashes a cascade of events that damage the wire-like arms of nerve cells (axons) and the insulating tissue (myelin) that wraps around axons, disrupting nerve signal transmission.

Driving solutions

Research focusing on understanding the extent and causes of damage to the nervous system in MS is driving progress that will help us find ways to protect the brain and stop disease progression. Current research approaches funded by the Society's research programs include:
  • Investigating whether debris from damage caused by the immune attack causes further damage to nerve cells during the course of MS.
  • Exploring how alterations in the myelin coating after immune attacks affect the health and behavior of nerve fibers.
  • Identifying processes that contribute to the loss of myelin and ways to restore myelin to protect nerves and their function.
  • Seeking ways to diagnose MS earlier to enable earliest treatment as the best insurance against future damage.
  • Developing high-powered imaging as a window to seeing how MS causes damage and as a tool for tracking the success of treatments.
Past Success
The MS Lesion Project was a major collaboration of investigators worldwide who sought to understand the damage MS does to the nervous system and ultimately improve its treatment. This large-scale project was funded through the Society’s Promise: 2010 Initiative.

investigators sought to understand patterns of MS damage in lesions—spots of brain tissue where myelin has been stripped from nerve fibers. Claudia F. Lucchinetti, MD, with collaborators in the U.S., Germany and Austria, launched the most extensive attempt ever to map and understand the meaning of MS damage in the brain. They amassed an unprecedented collection of tissue samples from more than 1,000 people with MS, obtained from brain biopsies (a rare procedure) or autopsies. By identifying four distinct kinds of lesion patterns, the collaborators: 
  • changed the way researchers think about MS
  • discovered that unique antibody patterns are associated with different lesion patterns, which could lead to a blood test to help inform treatment decisions
  • made significant gains in understanding when lesions form and how tissue is damaged, opening up new possibilities for strategies to stop that damage
An additional grant from the National Institutes of Health is making it possible for these investigators to continue making discoveries about tissue damage in MS that may ultimately drive treatment decisions.

We are making progress

Researchers funded by the Society reported that a specific type of nerve cell called “projection neurons” – which normally facilitate communication between different areas of the brain – are especially vulnerable to damage in the cortex (the outer region of the brain, associated with disease progression and cognitive impairment).

Researchers reported greater tissue loss in particular areas of the brain and spinal cord in a small, three-year MRI  study comparing MS-related changes in African Americans and Caucasian Americans. This study, although small, adds to the body of work exploring why Black people may experience a more severe MS course than white people. It also underscores why it’s important for  African Americans with MS to participate in clinical trials of therapies that might protect or repair brain and spinal cord tissues, to detect whether there are differences in treatment response between people of difference races and ethnicities.


© 2023 The National Multiple Sclerosis Society is a tax exempt 501(c)3 nonprofit organization. Its Identification Number (EIN) is 13-5661935.