Lublin Fred D, Reingold Stephen C, Cohen Jeffrey A, Cutter Gary R, Sørensen Per Soelberg, Thompson Alan J, Wolinsky Jerry S, Balcer Laura J, Banwell Brenda, Barkhof Frederik, Bebo Bruce, Calabresi Peter A, Clanet Michel, Comi Giancarlo, Fox Robert J, Freedman Mark S, Goodman Andrew D, Inglese Matilde, Kappos Ludwig, Kieseier Bernd C, Lincoln John A, Lubetzki Catherine, Miller Aaron E, Montalban Xavier, O'Connor Paul W, Petkau John, Pozzilli Carlo, Rudick Richard A, Sormani Maria Pia, Stüve Olaf, Waubant Emmanuelle, Polman Chris H
From the Corinne Goldsmith Dickenson Center for Multiple Sclerosis (F.D.L., A.E.M.), Icahn School of Medicine at Mount Sinai, New York, NY; Scientific and Clinical Review Associates, LLC (S.C.R.), Salisbury, CT; The Mellen Center for MS Treatment and Research (J.A.C., R.J.F., R.A.R.), Cleveland Clinic, OH; the Department of Biostatistics (G.R.C.), University of Alabama at Birmingham; the Danish Multiple Sclerosis Center (P.S.S.), Department of Neurology, Copenhagen University Hospital Rigshospitalet, Denmark; University College London Institute of Neurology (A.J.T.), UK; the Department of Neurology (J.S.W., J.A.L.), University of Texas Health Sciences Center, Houston; the Department of Neurology (L.J.B.), New York University Langone Medical Center, New York; the Division of Neurology (B. Banwell), The Children's Hospital of Philadelphia, PA; the Departments of Radiology and Nuclear Medicine (F.B.) and Neurology (C.H.P.), VU Medical Center, Amsterdam, the Netherlands; Research Programs Department (B. Bebo), National Multiple Sclerosis Society, New York, NY; the Department of Neurology (P.A.C.), The Johns Hopkins Hospital, Baltimore, MD; Fédération de Neurologie (M.C.), CHU Hôpital Purpan, Toulouse, France; the Department of Neurology (G.C.), Scientific Institute San Raffaele, University Vita-Salute San Raffaele, Milan, Italy; University of Ottawa and the Ottawa Hospital Research Institute (M.S.F.), Canada; the Department of Neurology (A.D.G.), University of Rochester Medical Center, NY; the Departments of Neurology, Radiology and Neuroscience (M.I.), Mount Sinai School of Medicine, New York, NY; the Department of Neurology (L.K.), University Hospital, Basel, Switzerland; the Department of Neurology (B.C.K.), Heinrich-Heine-University, Düsseldorf, Germany; the Department of Neurology (C.L.), Salpêtrière Hospital, UPMC, Paris, France; the Department of Neurology-Neuroimmunology (X.M.), Cemcat, Hospital Universitari Vall d'Hebron, Barcelona, Spain; the Division of
Neurology. 2014 Jul 15;83(3):278-86. doi: 10.1212/WNL.0000000000000560. Epub 2014 May 28.
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.
准确描述多发性硬化症（MS）的临床病程（表型）对于交流、预后判断、临床试验的设计与招募以及治疗决策都非常重要。1996年基于对国际MS专家的调查发布的标准化描述，当时仅根据数据和共识提供了纯临床表型，但缺乏影像学和生物学关联。对MS及其病理学的认识不断加深，再加上人们普遍担心最初的描述符可能无法充分反映该疾病最近发现的临床特征，促使MS临床试验国际咨询委员会重新审视MS疾病表型。虽然缺乏可能为区分临床表型提供客观标准的影像学和生物学标志物，但我们提出了更精细的描述符，其中包括考虑疾病活动（基于临床复发率和影像学结果）和疾病进展。还概述了未来更好地定义表型的研究策略。
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