Hi Bearygood. I'm a member of the black hole club too! Apparently I had a handful of them along with some regular lesions when I was diagnosed almost 2 years ago. But I have had minimal if no MS symptoms since then and no relapses. I was quickly diagnosed with O.N./dizziness/minor cognitive stuff but it was so mild the neuro told me I was his healthiest patient in the hospital while getting IV steroids. I'm on Tysabri, about to have #12 and another MRI. No change at #6 on the MRI. Actually, I wasn't on DMD's for 6 months at the beginning and no changes either. So I am living proof that you can have black holes and really no clinical symptoms. I hate the sound of "black hole" though. Why can't they just call them "old lesions?!" The neuro that I saw at the Mayo Clinic scared the carp out of me and told me I needed to be on the more powerful MS meds because it didn't look like my brain was healing (hence black holes). They do scare me a lot but I try not to think about them in my brain. I also try not to read about them too much online either because then then I really get freaked out!