Largest MS brain cohort reveals biological differences

6 july 2026

In a new publication, first authors Lukas Lütje and Alida Chen analysed pathological, clinical, and genetic data from 287 people with MS who donated their brain to the Netherlands Brain Bank. It is the largest well-characterised MS pathology cohort currently available.

The researchers examined whether people with MS show distinct patterns of brain damage and repair. They focused on four pathological characteristics: inflammation around blood vessels, clusters of immune cells in the brain, the presence of broad rim lesions, and the brain’s ability to repair myelin—the protective coating around nerve fibres.

The team found that these four pathological characteristics were associated with different patterns of lesion activity, tissue repair, and disease severity. For example, people with broad rim lesions were more likely to have a more severe disease course, while those with poor capacity for myelin repair had more chronic tissue damage.

Genetic variants known to increase the risk of developing MS were more common in people with inflammation around blood vessels and clusters of the brain’s immune cells, suggesting that genetic background contributes to the inflammatory processes occurring in the brain. Another genetic variant, previously associated with faster disease progression, was more frequently observed in people with broad rim lesions.

By combining pathology, genetics and clinical information, the researchers were able to identify donor-specific pathological features that help explain why MS differs so much between individuals.

Source: Acta Neuropathologica