1. Deciphering Multiple Sclerosis Progression
- Author
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Virginia Meca-Lallana, Leticia Berenguer-Ruiz, Joan Carreres-Polo, Sara Eichau-Madueño, Jaime Ferrer-Lozano, Lucía Forero, Yolanda Higueras, Nieves Téllez Lara, Angela Vidal-Jordana, Francisco Carlos Pérez-Miralles, Institut Català de la Salut, [Meca-Lallana V] Multiple Sclerosis Unit, Neurology Department, Fundación de Investigación Biomédica, Hospital Universitario de la Princesa, Madrid, Spain. [Berenguer-Ruiz L] Neurology Department, Hospital Marina Baixa, Alicante, Spain. [Carreres-Polo J] Neuroradiology Section, Radiology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain. [Eichau-Madueño S] Multiple Sclerosis CSUR Unit, Neurology Department, Hospital Universitario Virgen Macarena, Seville, Spain. [Ferrer-Lozano J] Department of Pathology, Hospital Universitari i Politècnic La Fe, Valencia, Spain. [Forero L] Neurology Department, Hospital Puerta del Mar, Cádiz, Spain. [Vidal-Jordana A] Servei de Neurologia/Neuroimmunologia, Centre d'Esclerosi Múltiple de Catalunya (CEMCAT), Barcelona, Spain. Vall d'Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
- Subjects
Oncology ,medicine.medical_specialty ,Other subheadings::Other subheadings::/physiopathology [Other subheadings] ,Otros calificadores::Otros calificadores::/fisiopatología [Otros calificadores] ,Esclerosi múltiple - Propensió ,Genetic Phenomena::Genotype::Genetic Predisposition to Disease [PHENOMENA AND PROCESSES] ,Review ,Disease ,neurofilament ,Esclerosi múltiple - Fisiologia patològica ,multiple sclerosis ,lcsh:RC346-429 ,Sistema nerviós - Degeneració ,03 medical and health sciences ,0302 clinical medicine ,Degenerative disease ,Internal medicine ,medicine ,In patient ,030212 general & internal medicine ,enfermedades del sistema nervioso::enfermedades neurodegenerativas [ENFERMEDADES] ,lcsh:Neurology. Diseases of the nervous system ,fenómenos genéticos::genotipo::predisposición genética a la enfermedad [FENÓMENOS Y PROCESOS] ,Expanded Disability Status Scale ,business.industry ,Multiple sclerosis ,Neurodegeneration ,Disease progression ,neurodegeneration ,Nervous System Diseases::Autoimmune Diseases of the Nervous System::Demyelinating Autoimmune Diseases, CNS::Multiple Sclerosis [DISEASES] ,medicine.disease ,Clinical trial ,progressive multiple sclerosis ,Neurology ,Nervous System Diseases::Neurodegenerative Diseases [DISEASES] ,enfermedades del sistema nervioso::enfermedades autoinmunitarias del sistema nervioso::enfermedades autoinmunes desmielinizantes del SNC::esclerosis múltiple [ENFERMEDADES] ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,MRI - Abstract
Esclerosi múltiple; Neurodegeneració Esclerosis múltiple; Neurodegeneración Multiple sclerosis; Nneurodegeneration Multiple sclerosis (MS) is primarily an inflammatory and degenerative disease of the central nervous system, triggered by unknown environmental factors in patients with predisposing genetic risk profiles. The prevention of neurological disability is one of the essential goals to be achieved in a patient with MS. However, the pathogenic mechanisms driving the progressive phase of the disease remain unknown. It was described that the pathophysiological mechanisms associated with disease progression are present from disease onset. In daily practice, there is a lack of clinical, radiological, or biological markers that favor an early detection of the disease's progression. Different definitions of disability progression were used in clinical trials. According to the most descriptive, progression was defined as a minimum increase in the Expanded Disability Status Scale (EDSS) of 1.5, 1.0, or 0.5 from a baseline level of 0, 1.0–5.0, and 5.5, respectively. Nevertheless, the EDSS is not the most sensitive scale to assess progression, and there is no consensus regarding any specific diagnostic criteria for disability progression. This review document discusses the current pathophysiological concepts associated with MS progression, the different measurement strategies, the biomarkers associated with disability progression, and the available pharmacologic therapeutic approaches.
- Published
- 2021