RT Journal Article
SR Electronic
T1 Toward Precision Phenotyping of Multiple Sclerosis
JF Neurology - Neuroimmunology Neuroinflammation
JO Neurol Neuroimmunol Neuroinflamm
FD Lippincott Williams & Wilkins
SP e200025
DO 10.1212/NXI.0000000000200025
VO 9
IS 6
A1 David Pitt
A1 Chih Hung Lo
A1 Susan A. Gauthier
A1 Richard A. Hickman
A1 Erin Longbrake
A1 Laura M. Airas
A1 Yang Mao-Draayer
A1 Claire Riley
A1 Philip Lawrence De Jager
A1 Sarah Wesley
A1 Aaron Boster
A1 Ilir Topalli
A1 Francesca Bagnato
A1 Mohammad Mansoor
A1 Olaf Stuve
A1 Ilya Kister
A1 Daniel Pelletier
A1 Panos Stathopoulos
A1 Ranjan Dutta
A1 Matthew R. Lincoln
YR 2022
UL http://nn.neurology.org/content/9/6/e200025.abstract
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