Defining the clinical course of multiple sclerosis: the 2013 revisions

Subscribe to email list

Please select the email list(s) to which you wish to subscribe.

You are here

Defining the clinical course of multiple sclerosis: the 2013 revisions

TitleDefining the clinical course of multiple sclerosis: the 2013 revisions
Publication TypeJournal Article
Year of Publication2014
AuthorsLublin, FD, Reingold, SC, Cohen, JA, Cutter, GR, Soelberg-Sorensen, P, Thompson, AJ, Wolinsky, JS, Balcer, LJ, Banwell, B, Barkhof, F, Bebo, B, Calabresi, PA, Clanet, M, Comi, G, Fox, RJ, Freedman, MS, Goodman, AD, Inglese, M, Kappos, L, Kieseier, BC, Lincoln, JA, Lubetzki, C, Miller, AE, Montalban, X, O'Connor, PW, Petkau, J, Pozzilli, C, Rudick, RA, Sormani, MP, Stueve, O, Waubant, E, Polman, CH
JournalNeurology
Volume83
Pagination278-286
Date PublishedJUL 15
Type of ArticleReview
ISSN0028-3878
Abstract

Accurate clinical course descriptions (phenotypes) of multiple sclerosis (MS) are important for communication, prognostication, design and recruitment of clinical trials, and treatment decision-making. Standardized descriptions published in 1996 based on a survey of international MS experts provided purely clinical phenotypes based on data and consensus at that time, but imaging and biological correlates were lacking. Increased understanding of MS and its pathology, coupled with general concern that the original descriptors may not adequately reflect more recently identified clinical aspects of the disease, prompted a re-examination of MS disease phenotypes by the International Advisory Committee on Clinical Trials of MS. While imaging and biological markers that might provide objective criteria for separating clinical phenotypes are lacking, we propose refined descriptors that include consideration of disease activity (based on clinical relapse rate and imaging findings) and disease progression. Strategies for future research to better define phenotypes are also outlined.