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Black holes – in German black holes – are foci of inflammation that appear black in the middle and have a light border on special magnetic resonance imaging (MRT) images, so-called T-1 weighted MRI images. Their appearance therefore differs from the white appearance. / clear of conventional foci of inflammation (lesions) on MRI images.
The black color on the MRI image is due to the fact that CSF has accumulated in the center of the lesion. The reason for this: the center of inflammation has expanded so rapidly that the tissue has thinned at this point and the liquor fills the space created in this way. CSF appears black on MRI images.
What is Black Holes about?
According to studies, not only the lining of nerve fibers, myelin, is damaged in so-called black holes, but also some cells, the so-called oligodendrocytes, which form myelin. This means that remedial measures for oligodendrocytes can no longer take effect here. In black holes, the nerve cells, or more precisely the axons, which transmit information between nerve cells, are permanently damaged. This, in turn, causes neurological breakdowns, i.e. certain movements are, after a certain extent of damage, u. U. is no longer possible.
While other injuries regress – at least partially – and the physical functions believed to have been lost may return to some extent, the nerve tissue in black holes is irrevocably lost. However, there is always the possibility that other areas of the brain may do so. U can at least partially compensate for nerve cell failure. However, from a medical point of view it is not possible to restore the affected areas in the central nervous system.
Black holes don’t occur in all people with MS. Scientists therefore suspect that the presence of black holes indicates a more aggressive course of MS.
Can you prevent black holes?
According to current knowledge, medical professionals assume that early course-modifying therapy can prevent the development of black holes. Therefore, it makes sense to start long-term therapy as soon as possible after MS diagnosis and to stick with it. Various medications are available to treat relapsing MS, so that if side effects occur, your doctor can help you. U. can prescribe another drug. A course-modifying therapy usually reduces the occurrence of relapses and thus also the development of lesions.
If physical symptoms occur as a result of existing black holes, symptomatic therapy should also be started as soon as possible. Sometimes a specific treatment (eg speech therapy, physiotherapy) can compensate for physical limitations, at least to some extent.
Source: MS 2/2017 results
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