Deciphering Multiple Sclerosis Progression.
Por:
Meca-Lallana, V, Berenguer-Ruiz, L, Carreres-Polo, J, Eichau-Madueno, S, Ferrer-Lozano, J, Forero, L, Higueras, Y, Lara, N, Vidal-Jordana, A and Perez-Miralles, F
Publicada:
7 abr 2021
Ahead of Print:
7 abr 2021
Resumen:
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.
Filiaciones:
Meca-Lallana, V:
Hosp Univ Princesa, Neurol Dept, Multiple Sclerosis Unit, Fdn Invest Biomed, Madrid, Spain
:
Hosp Marina Baixa, Neurol Dept, Alicante, Spain
Carreres-Polo, J:
Hosp Univ & Politecn La Fe, Radiol Dept, Neuroradiol Sect, Valencia, Spain
Eichau-Madueno, S:
Hosp Univ Virgen Macarena, Neurol Dept, Multiple Sclerosis CSUR Unit, Seville, Spain
Ferrer-Lozano, J:
Hosp Univ & Politecn La Fe, Dept Pathol, Valencia, Spain
Forero, L:
Hosp Puerta del Mar, Neurol Dept, Cadiz, Spain
Higueras, Y:
Hosp Univ Gregorio Maranon, Neurol Dept, Inst Invest Sanitaria Gregorio Maranon IISGM, Madrid, Spain
Univ Complutense, Dept Expt Psychol Cognit Proc & Speech Therapy, Madrid, Spain
Lara, N:
Hosp Clin Univ Valladolid, Neurol Dept, Valladolid, Spain
Vidal-Jordana, A:
Hosp Univ Vall dHebron, Ctr Esclerosi Multiple Catalunya Cemcat, Neurol Neuroimmunol Dept, Barcelona, Spain
Perez-Miralles, F:
Hosp Univ & Politecn La Fe, Neurol Dept, Neuroimmunol Unit, Valencia, Spain
Univ Valencia, Dept Med, Valencia, Spain
Green Published, gold
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