ClinicSpeak: when does progressive MS begin?

Moving beyond NEDA: preventing end-organ damage #ClinicSpeak #MSBlog #MSResearch

"Mouse Doc's post this morning on retinal nerve fibre loss in early MS is a stark reminder that the progressive phase of MS is present from the earliest stages of MS. It is now clear that some MSers already have lost substantial brain, and retinal tissue, when they present with their first clinical attack of MS (CIS). Even a  proportion of RISers (people with asymptomatic MS or radiologically isolated syndromes) have brain volume loss and subtle cognitive deficits when investigated. Therefore the idea that progressive MS begins later in the course of the disease is inaccurate. We simply have to accept that the pathological processes driving progressive MS (neuronal loss) are present from the earliest stages of the disease. The quicker we accept this the sooner the community will accept the responsibility of moving beyond NEDA (no evident disease activity) and start to focus on preventing end-organ damage (brain volume loss or atrophy) and promoting brain health as the new therapeutic target in MS. HCPs (healthcare professionals) need to take up the challenge and the responsibility of maximising the brain function and health of the MSers in their care. Why wouldn't MSers' want to maximise the health of their brains?"

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