4.7 Review

A focus on secondary progressive multiple sclerosis (SPMS): challenges in diagnosis and definition

Journal

JOURNAL OF NEUROLOGY
Volume 268, Issue 4, Pages 1210-1221

Publisher

SPRINGER HEIDELBERG
DOI: 10.1007/s00415-019-09489-5

Keywords

SPMS; Diagnosis; Definition; Screening; Endpoints

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Secondary progressive multiple sclerosis (SPMS) is the second most common form of MS, characterized by a gradual decrease in neurological function and limitation of daily activities. Due to various factors, the diagnosis of SPMS is often delayed, with a lack of definitive clinical diagnostic criteria, necessitating further research and exploration of new methods.
Secondary progressive multiple sclerosis (SPMS) is the second most common form of multiple sclerosis (MS). One in two relapse remitting multiple sclerosis (RRMS) patients will develop SPMS within 15 years and up to two-thirds after 30 years, leading to a progressive decrease of neurological function and limitation of daily activities. Nevertheless, the SPMS diagnosis is often established retrospectively and delayed up to 3 years due to several patient- and clinician-related factors. Definitive clinical diagnostic criteria are lacking and research is currently ongoing to identify imaging and biochemical biomarkers. As new therapies are introduced, early SPMS diagnosis may represent a window of opportunity for intervention. New approaches, endpoints or technologies could help physicians establishing a diagnosis. Here, we review SPMS in relation to its diagnostic and definition challenges and current screening techniques and tools.

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