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Related Concept Videos

Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...

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Assessing treatment response in multiple sclerosis.

Fabian Föttinger1,2, Nik Krajnc1,2, Gabriel Bsteh1,2

  • 1Department of Neurology.

Current Opinion in Neurology
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Monitoring multiple sclerosis (MS) requires advanced methods beyond traditional clinical assessments. Integrating imaging and fluid biomarkers with clinical evaluations improves detection of disease activity and personalizes treatment decisions for better outcomes.

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Area of Science:

  • Neurology
  • Immunology
  • Biomarker Research

Background:

  • Multiple sclerosis (MS) management is evolving from a relapse-focused approach to understanding continuous inflammatory and neurodegenerative processes.
  • Traditional clinical measures inadequately capture the full disease progression and long-term disability.
  • Subtle clinical deterioration and insidious progression necessitate more sensitive monitoring strategies.

Purpose of the Study:

  • To review the evolving landscape of multiple sclerosis (MS) treatment response evaluation.
  • To highlight the limitations of traditional clinical measures in detecting disease progression.
  • To emphasize the need for integrated monitoring strategies incorporating advanced assessments.

Main Methods:

  • Review of current clinical assessment tools and their limitations.
  • Evaluation of advanced functional assessments for enhanced sensitivity.
  • Assessment of Magnetic Resonance Imaging (MRI) for detecting subclinical inflammatory activity.
  • Analysis of neurodegenerative biomarkers, including optical coherence tomography (OCT) and fluid biomarkers (serum neurofilament light chain [sNfL], glial fibrillary acidic protein [GFAP]).

Main Results:

  • Traditional clinical measures are insufficient for detecting subtle disease progression and long-term disability.
  • Enhanced functional assessments offer greater sensitivity to clinical changes.
  • MRI is crucial for identifying subclinical focal inflammatory activity.
  • Biomarkers like OCT, sNfL, and GFAP provide insights into diffuse neurodegenerative processes.

Conclusions:

  • A personalized monitoring strategy integrating clinical assessment, imaging, and fluid biomarkers is essential for contemporary MS care.
  • This integrated approach promises improved detection of subclinical disease activity.
  • It enables more accurate risk stratification and informed, individualized treatment decisions.