Benign multiple sclerosis: a need for a consensus.

Area of Science:

• Neurology
• Clinical Research
• Epidemiology

Background:

• Multiple Sclerosis (MS) is a chronic neurological disease.
• Defining benign MS is crucial for understanding disease course and patient outcomes.
• Previous studies have varied in their definitions of benign MS.

Purpose of the Study:

• To evaluate how different definitions affect the estimated frequency of benign multiple sclerosis (MS).
• To assess the association between various benign MS definitions and the presence of non-motor symptoms.
• To examine employment status in relation to different benign MS classifications.

Main Methods:

• A cohort of 188 patients with MS onset between 1976-1986 in Hordaland County, Norway, were followed up.
• Clinical examinations included the Expanded Disability Status Scale (EDSS) in 2003.
• Benign MS was defined using EDSS cut-offs (2.0, 3.0, 4.0) and employment status.

Main Results:

• Benign MS frequency ranged from 14.5% (EDSS ≤2.0) to 40.8% (EDSS ≤4.0).
• Using full-time employment as a criterion yielded only 12.3% benign MS.
• Patients with EDSS ≤2.0 reported fewer non-motor symptoms and lower unemployment.

Conclusions:

• An EDSS score of 2.0 or less, combined with at least 10 years of disease duration, is proposed as the most suitable criterion for identifying benign MS.
• This definition is associated with a better patient experience regarding non-motor symptoms and employment.
• Refining the definition of benign MS is essential for accurate clinical assessment and prognosis.