PT  - JOURNAL ARTICLE
AU  - David Pitt
AU  - Chih Hung Lo
AU  - Susan A. Gauthier
AU  - Richard A. Hickman
AU  - Erin Longbrake
AU  - Laura M. Airas
AU  - Yang Mao-Draayer
AU  - Claire Riley
AU  - Philip Lawrence De Jager
AU  - Sarah Wesley
AU  - Aaron Boster
AU  - Ilir Topalli
AU  - Francesca Bagnato
AU  - Mohammad Mansoor
AU  - Olaf Stuve
AU  - Ilya Kister
AU  - Daniel Pelletier
AU  - Panos Stathopoulos
AU  - Ranjan Dutta
AU  - Matthew R. Lincoln
TI  - Toward Precision Phenotyping of Multiple Sclerosis
AID  - 10.1212/NXI.0000000000200025
DP  - 2022 Nov 01
TA  - Neurology - Neuroimmunology Neuroinflammation
PG  - e200025
VI  - 9
IP  - 6
4099  - http://nn.neurology.org/content/9/6/e200025.short
4100  - http://nn.neurology.org/content/9/6/e200025.full
SO  - Neurol Neuroimmunol Neuroinflamm2022 Nov 01; 9
AB  - The classification of multiple sclerosis (MS) has been established by Lublin in 1996 and revised in 2013. The revision includes clinically isolated syndrome, relapsing-remitting, primary progressive and secondary progressive MS, and has added activity (i.e., formation of white matter lesions or clinical relapses) as a qualifier. This allows for the distinction between active and nonactive progression, which has been shown to be of clinical importance. We propose that a logical extension of this classification is the incorporation of additional key pathological processes, such as chronic perilesional inflammation, neuroaxonal degeneration, and remyelination. This will distinguish MS phenotypes that may present as clinically identical but are driven by different combinations of pathological processes. A more precise description of MS phenotypes will improve prognostication and personalized care as well as clinical trial design. Thus, our proposal provides an expanded framework for conceptualizing MS and for guiding development of biomarkers for monitoring activity along the main pathological axes in MS.DMT=disease-modifying treatment; MS=multiple sclerosis; NAWM=normal-appearing white matter; NfL=neurofilaments; PPMS=primary progressive MS; RRMS=relapsing-remitting MS; WM=white matter