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“All we really understand about neurological disease we have learned from pathological studies.”
Self evidently not a perfect truth, but it is a fair approximation, particularly if “understand” is properly weighted. Take multiple sclerosis as a random example. We have been taught a great deal about the course and dynamics of the disease—for example, by new imaging techniques, but MRI has come closest to contributing to our understanding of the disorder when married to pathological studies, or when used as a surrogate marker of pathology. The huge power of the new genetics has now set its sights on multiple sclerosis, and although proceeding apace and well in to the genome screen approach, it too has yet to contribute major insights to our understanding of multiple sclerosis. Animal models, even the aged EAE, can only offer suggestions which live or die according to correlative studies of multiple sclerosis tissue or patients. And my own area of interest, the cell biology of oligodendrocytes studied (mostly) by cell culture, is no better or worse than these …