Review: Mitochondria and disease progression in multiple sclerosis
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Updated: Jun 27, 2026

Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
D Mahad1, H Lassmann, D Turnbull
1The Mitochondrial Research Group, University of Newcastle upon Tyne, Newcastle, UK. d.j.mahad@ncl.ac.uk
Abstract:
Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system. Recent evidence suggests that dysfunction of surviving demyelinated axons and axonal degeneration contribute to the progression of MS. We review the evidence for and potential mechanisms of degeneration as well as dysfunction of chronically demyelinated axons in MS with particular reference to mitochondria, the main source of adenosine-5'-triphosphate in axons. Besides adenosine-5'-triphosphate production, mitochondria play an important role in calcium handling and produce reactive oxygen species. The mitochondrial changes in axons lacking healthy myelin sheaths as well as redistribution of sodium channels suggest that demyelinated axons would be more vulnerable to energy deficit than myelinated axons. A dysfunction of mitochondria in lesions as well as in the normal-appearing white and grey matter is increasingly recognized in MS and could be an important determinant of axonal dysfunction and degeneration. Mitochondria are a potential therapeutic target in MS.
Insights
Mitochondrial dysfunction in demyelinated axons contributes to multiple sclerosis (MS) progression. Targeting mitochondria may offer a therapeutic strategy for MS axonal degeneration.
Area of Science:
- Neuroscience
- Cell Biology
- Pathology
Background:
- Multiple sclerosis (MS) is a central nervous system inflammatory demyelinating disease.
- Axonal dysfunction and degeneration are key drivers of MS progression.
Purpose of the Study:
- To review evidence and mechanisms of demyelinated axon degeneration in MS.
- To highlight the role of mitochondria in axonal dysfunction and degeneration in MS.
Main Methods:
- Literature review focusing on mitochondrial roles in demyelinated axons.
- Analysis of evidence linking mitochondrial dysfunction to axonal vulnerability in MS.
Main Results:
- Demyelinated axons exhibit mitochondrial changes and sodium channel redistribution.
- These alterations suggest increased vulnerability to energy deficits.
- Mitochondrial dysfunction is observed in MS lesions and normal-appearing brain matter.
Conclusions:
- Mitochondrial dysfunction is a significant factor in axonal dysfunction and degeneration in MS.
- Mitochondria represent a promising therapeutic target for managing MS progression.
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