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Commentary in Neurology
March 2009

We Should Use Magnetic Resonance Imaging to Classify and Monitor the Course of Multiple Sclerosis

Author Affiliations

E. S.RoachMDAuthor Affiliations:Department of Neurology and Neuroscience, University of Medicine and Dentistry of New Jersey, Newark (Drs Lincoln, Cadavid, and Cook) and Neurology Service, East Orange VA Medical Center, East Orange (Dr Dowling); and Institute of Clinical Neurosciences, Department of Medicine, University of Sydney, Sydney, Australia (Drs Pollard, McLeod, and Prineas).

Arch Neurol. 2009;66(3):412-414. doi:10.1001/archneurol.2009.26

Disease activity in multiple sclerosis (MS) consists of acute exacerbations that can be either clinical or subclinical (seen on magnetic resonance imaging [MRI]) and incremental increases in disability that can be related to relapses or occur independently of them. In 1996, Lublin and Reingold1developed a consensus disease course classification for MS that is now widely used. Persons who demonstrate an acute or subacute clinical exacerbation associated with transient or persistent neurological deficits are assigned into a “relapsing” form while those who accrue disability either without documented exacerbations or superimposed on clinical exacerbations fall into a more “progressive” category. While quite useful, a potential deficiency of this classification is the lack of formally incorporating MRI measures of disease activity.

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