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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...
Myasthenia Gravis ll: Pathophysiology01:22

Myasthenia Gravis ll: Pathophysiology

The disease process of myasthenia gravis begins at the neuromuscular junction, where antibodies attack key proteins needed for muscle activation. This immune reaction weakens signal transmission, leading to the characteristic muscle fatigue and weakness that define the condition.Immune-Mediated DamageIn most individuals, antibodies target acetylcholine receptors (AChRs) on the postsynaptic membrane of muscle cells. By blocking acetylcholine binding, these antibodies prevent the nerve signal...
Autoimmune Disorders01:29

Autoimmune Disorders

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Concept and Mechanism of Autoimmune Diseases
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Secondary Spinal Cord Injury llI: Pathophysiology01:25

Secondary Spinal Cord Injury llI: Pathophysiology

Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...
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Th1 cells stimulate dendritic cells to express necessary co-stimulatory molecules on their surfaces for...
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Challenges and future directions for multiple sclerosis after the 2024 McDonald diagnostic criteria.

Nature medicine·2026
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Profiling the long-term risk of severe adverse events in a cohort of multiple sclerosis patients treated with different treatment sequences: Results from the Italian Multiple Sclerosis and Related Disorders Registry (I-MS&RD) (ProSA study).

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Related Experiment Video

Updated: Jul 15, 2026

Scoring Central Nervous System Inflammation, Demyelination, and Axon Injury in Experimental Autoimmune Encephalomyelitis
08:17

Scoring Central Nervous System Inflammation, Demyelination, and Axon Injury in Experimental Autoimmune Encephalomyelitis

Published on: February 23, 2024

Multiple sclerosis as an asynchronous neuroinflammatory system.

Emanuele D'Amico1, Aurora Zanghì1, Daniel Ontaneda2

  • 1Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.

Frontiers in Immunology
|July 14, 2026
PubMed
Summary

Multiple sclerosis (MS) is not just an event-driven disorder but a dynamically evolving system. Understanding its complex progression beyond relapses is crucial for accurate prognosis and treatment.

Keywords:
asynchronous dynamicsclinical trial modelingdisease progressionmultidimensional state spacemultiple sclerosis

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Induction of Experimental Autoimmune Encephalomyelitis in Mice and Evaluation of the Disease-dependent Distribution of Immune Cells in Various Tissues
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Induction and Diverse Assessment Indicators of Experimental Autoimmune Encephalomyelitis
06:19

Induction and Diverse Assessment Indicators of Experimental Autoimmune Encephalomyelitis

Published on: September 9, 2022

Area of Science:

  • Neurology
  • Immunology
  • Biomedical Imaging

Background:

  • Multiple sclerosis (MS) traditionally viewed through a linear, event-based framework.
  • Recent evidence suggests independent temporal dynamics in MS pathology and progression.
  • 2024 McDonald criteria update incorporates immune persistence and chronic inflammation markers.

Purpose of the Study:

  • To challenge the event-driven model of MS.
  • To propose a new conceptual framework for understanding MS progression.
  • To highlight implications for prognosis, trial design, and therapeutic modeling.

Main Methods:

  • Review and synthesis of pathological, imaging, biomarker, and clinical trial data.
  • Analysis of diagnostic criteria evolution (McDonald criteria).
  • Decomposition of disability accumulation into Relapse-associated worsening (RAW) and Progression Independent of Relapse Activity (PIRA).

Main Results:

  • MS pathology, lesion expansion, and network changes exhibit independent temporal dynamics.
  • Dissemination in Space (DIS) is key for diagnosis, but prognosis requires more than event frequency.
  • Disability progression is a complex interplay of RAW and PIRA, challenging relapse-centered models.
  • Traditional endpoints like ARR and CDP offer partial views of a multidimensional disease process.

Conclusions:

  • Multiple sclerosis should be reconceptualized as a dynamically evolving system, not an event-driven disorder.
  • Disease progression follows a trajectory through a multidimensional state space (MSS).
  • This paradigm shift impacts prognostic inference, clinical trial design, biomarker integration, and state-dependent therapies.