Included among these are demyelination, axonal loss, neuroendocrine dysregulation[15], microstructural abnormalities and regional atrophy [46], altered patterns of cerebral activation[22], inflammation and accompanying immunoactivation; pro-inflammatory cytokines (particularly TNF alpha, IL-6, and interferon-γ) are also thought to contribute to MS-related fatigue[47–49]. This evidence concerns the gene TNF and myeloid sarcoma.