Recent Advances in Diagnostic, Prognostic, and Disease-Monitoring Biomarkers in Multiple Sclerosis

Decisional Conflict Regarding Disease-Modifying Treatment Choices Among Patients with Mid-Stage Relapsing-Remitting Multiple Sclerosis

“… 42 RRMS is a paradigmatic example for investigating the decisional conflict due to the unpredictable trajectory of the disease and the numerous treatment options available, each differing in efficacy, safety, and administration characteristics. 4 , 7 , 8 Decisional conflict arises when patients feel unsure about which treatment option to choose, have conflicting values or preferences, or lack adequate information to make a well-informed decision, fear of making the wrong choice, feelings of regret, and the tendency to blame physicians for unfavorable outcomes. 9 , 10 , 12 …”

“… 2 , 6 Furthermore, despite our increasing understanding of numerous prognostic factors, the disease’s natural course varies, often making it challenging for neurologists to reliably predict their patients’ long-term prognosis. 7 …”

Understanding multiple sclerosis as a disease spectrum: above and below the clinical threshold

“…Considering emerging MRI techniques to visualize the spectrum of MS, one can envision how a pathology-informed imaging assessment framework can further refine our approach to diagnostic [ 49 , 50 ▪ ] (e.g., Central Vein Sign [CVS], PRLs), prognostic (e.g., PRLs and MRI measures of atrophy including whole brain, substructure, and spinal cord), and disease monitoring for nonrelapsing progressive disease biology [ 36 , 51 , 52 ▪ ] (e.g., PRLs, SELs, PET) biomarkers across the spectrum of disease [ 52 ▪ ].…”