Defining the clinical course of multiple sclerosis: The 2013 revisions

Fred D. Lublin, Stephen C. Reingold, Jeffrey A. Cohen, Gary R. Cutter, Per Soelberg Sørensen, Alan J. Thompson, Jerry S. Wolinsky, Laura J. Balcer, Brenda Banwell, Frederik Barkhof, Bruce Bebo, Peter A. Calabresi, Michel Clanet, Giancarlo Comi, Robert J. Fox, Mark S. Freedman, Andrew D. Goodman, Matilde Inglese, Ludwig Kappos, Bernd C. KieseierJohn A. Lincoln, Catherine Lubetzki, Aaron E. Miller, Xavier Montalban, Paul W. O'Connor, John Petkau, Carlo Pozzilli, Richard A. Rudick, Maria Pia Sormani, Olaf Stüve, Emmanuelle Waubant, Chris H. Polman

Research output: Contribution to journalReview articlepeer-review

2014 Scopus citations


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.

Original languageEnglish
Pages (from-to)278-286
Number of pages9
Issue number3
StatePublished - 15 Jul 2014


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