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Commentary in Neurology |

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

John A. Lincoln, MD, PhD; Diego Cadavid, MD; John Pollard, MBBS, PhD; James McLeod, MBBS, PhD; John Prineas, MBBS; Peter Dowling, MD; Stuart D. Cook, MD
Arch Neurol. 2009;66(3):412-414. doi:10.1001/archneurol.2009.26.
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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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