Defining the clinical course of multiple sclerosis: The 2013 revisions

Abstract

Accurate clinical course descriptions (phenotypes) of multiple sclerosis (MS) are important for communication, prognostication, design and recruitment of clinical trials, and treatment decision-making. Standardized descriptions published in 1996 based on a survey of international MS experts provided purely clinical phenotypes based on data and consensus at that time, but imaging and biological correlates were lacking. Increased understanding of MS and its pathology, coupled with general concern that the original descriptors may not adequately reflect more recently identified clinical aspects of the disease, prompted a re-examination of MS disease phenotypes by the International Advisory Committee on Clinical Trials of MS. While imaging and biological markers that might provide objective criteria for separating clinical phenotypes are lacking, we propose refined descriptors that include consideration of disease activity (based on clinical relapse rate and imaging findings) and disease progression. Strategies for future research to better define phenotypes are also outlined.

Is multiple sclerosis a length-dependent central axonopathy? The case for therapeutic lag and the asynchronous progressive MS hypotheses

“…The definition of progressive MS disease has remained largely a clinical one based on the qualitative observation of " steadily increasing objectively documented neurologic dysfunction/disability without unequivocal recovery ". There is currently no consensus metric to identify and quantify progressive disease (Jacques and Lublin, 2015) .…”

Radiologically isolated syndrome as a possible preclinical stage of primary-progressive multiple sclerosis

“…В 2014 г. было предложено пересмотреть подход к классификации РС в зависимости от типа течения [15]. Новая фенотипическая классификация прогрессирующих форм РС подразумевает деление на активные и неактивные типы прогрессирования на основании клинических данных и данных МРТ.…”

Protective Effect of Aloe Vera Gel Extract on Histopathologic Changes in Ovaries and Gonadotropin in MS Model of Rat

“…In MS, the immune system attacks the nerve fibers of the myelin sheath and destroys myelin in many areas and remains a fibrous tissue (scar) instead, which is called sclerosis and damaged areas are called plaque. By destroying the myelin sheath or the nerve fiber itself, the ability to direct electrical impulses from the central nervous system to the organs and vice versa is disrupted, and this issue causes different symptoms of the disease in patient 2 . One of the most important problems with this disease is that a large number of people with MS are at reproductive age and the disease is more likely to develop in women than men 3 .…”