Title |
Evolving Concepts in the Pathogenesis of Multiple Sclerosis and their Therapeutic Implications |
Creator |
Rudick, RA |
Affiliation |
Mellen Center for Multiple Sclerosis Treatment and Research Department of Neurology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. |
Abstract |
Recent evidence suggests that multiple sclerosis (MS) is a continuously active neuropathologic process, even during the subclinical relapsing/remitting phase of the disease. Patients commonly feel well and function without disability for many years, experiencing only occasional relapses and nondisabling symptoms. In time, many evolve into a pattern of continuously progressive neurologic disability termed secondary progressive MS (SP-MS). SP-MS is hypothesized to occur once disease severity has exceeded a threshold. Above that threshold, compensatory mechanisms are inadequate to maintain normal function, and further disease progression is accompanied by progressively worsening disability. Inflammation dominates the early stage of disease. Progressive axonal pathology may underlie clinical disease progression in later stages. These concepts have important implications related to the diagnosis, methods for patient follow-up, type and timing of disease therapy, and the testing of neuroprotective drugs in MS. |
Subject |
Adjuvants, Immunologic/therapeutic use; Humans; Interferon-beta/therapeutic use; Magnetic Resonance Imaging; Multiple Sclerosis/drug therapy/etiology; Recurrence |
Format |
application/pdf |
Publication Type |
Journal Article |
Collection |
Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/ |
Publisher |
Lippincott, Williams & Wilkins |
Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah |
Rights Management |
© North American Neuro-Ophthalmology Society |
Setname |
ehsl_novel_jno |
ID |
225089 |
Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6md254v/225089 |