Assessing disease progression and treatment response in progressive multiple sclerosis

Area of Science:

• Neurology
• Immunology
• Biomarker Research

Background:

• Progressive multiple sclerosis (MS) presents diagnostic challenges due to complex pathophysiology.
• Traditional clinical measures like the Expanded Disability Status Scale (EDSS) offer limited insights into MS progression and treatment effects.
• Accurate assessment is vital for developing effective therapeutic strategies in progressive MS.

Purpose of the Study:

• To comprehensively review diverse tools for evaluating disease progression and treatment response in progressive multiple sclerosis (MS).
• To highlight the synergistic potential of integrating various assessment modalities for improved clinical decision-making.
• To guide the development of more effective therapeutic strategies for progressive MS.

Main Methods:

• Review of advanced imaging techniques (MRI, PET) for assessing neurodegeneration, atrophy, and lesion dynamics in MS.
• Analysis of cerebrospinal fluid and blood biomarkers, including neurofilament light chain (NfL), for neuro-axonal damage.
• Inclusion of patient-reported outcomes (PROs) to capture subjective experiences like fatigue and cognitive function.
• Exploration of emerging digital technologies and wearable devices for functional impairment monitoring in MS.

Main Results:

• Advanced imaging provides detailed insights into brain/spinal cord atrophy, lesion dynamics, and grey matter damage.
• Biomarkers, particularly NfL, show significant potential in indicating neuro-axonal damage in MS.
• Patient-reported outcomes are essential for understanding quality of life and treatment efficacy from the patient's perspective.
• Digital technologies offer future promise for enhanced monitoring of functional impairments and disease progression in MS.

Conclusions:

• A multimodal approach combining advanced imaging, biomarkers, patient-reported outcomes, and digital technologies is essential for accurate assessment of progressive MS.
• Integrated evaluation strategies will improve the understanding of disease progression and treatment efficacy.
• This comprehensive assessment approach will facilitate the development of more targeted and effective therapies for progressive MS.