We also found that there was a highly significant good positive correlation between presence MRI brain black holes and brain atrophy and CSF level of CHI3L1, which might be explained by the diffuse neurodegeneration and axonal loss along with ongoing astrocytic and microglial activation results in higher levels of CSF CHI3L1 in progressive MS, which was confirmed by many previous studies [31, 38]. The gene discussed is CHI3L1; the disease is myeloid sarcoma.