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Clinical scales for multiple sclerosis

B Sharrack1, R A Hughes

  • 1Department of Neurology, United Medical and Dental Schools, London, UK.

Journal of the Neurological Sciences
|January 1, 1996
PubMed
Summary
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Current multiple sclerosis (MS) disability scales have limitations. This study proposes guidelines for an improved scale to better assess MS impact and treatment efficacy in clinical trials.

Area of Science:

  • Neurology
  • Clinical Assessment
  • Multiple Sclerosis Research

Background:

  • Numerous neurological rating scales exist for multiple sclerosis (MS), but none achieve universal acceptance.
  • The Kurtzke Extended Disability Status Scale (EDSS) is widely used but has limitations, including a focus on ambulation and moderate reliability.
  • Existing scales often fail to adequately capture functional health status or the specific changes associated with MS progression.

Purpose of the Study:

  • To review the limitations of current neurological rating scales used in multiple sclerosis.
  • To propose guidelines for the development of an improved disability assessment scale for MS.
  • To enhance the evaluation of treatment efficacy in MS clinical trials.

Main Methods:

  • Review of existing neurological rating scales for multiple sclerosis, including the Kurtzke Extended Disability Status Scale, Scripps Neurological Rating Scale, Ambulation Index, Incapacity Status Scale, and Functional Independent Measure.

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  • Analysis of the strengths and weaknesses of each scale concerning reliability, relevance to functional status, and sensitivity to MS-specific changes.
  • Consideration of the role of neuroimaging in assessing MS disability.

    • Main Results:

    • Current scales exhibit significant limitations in comprehensively assessing multiple sclerosis disability and functional status.
    • Many scales lack direct relevance to patients' daily lives and are not sensitive to the nuances of MS progression.
    • The correlation between neuroimaging findings and clinical disability remains challenging to establish definitively.

    Conclusions:

    • There is a need for a more refined and universally accepted disability scale for multiple sclerosis.
    • An improved scale should better reflect functional health status and be sensitive to MS-specific changes.
    • Development of such a scale is crucial for accurately measuring treatment success in clinical trials.