Scott Thomas F
Department of Neurology, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, PA, United States.
J Neuroimmunol. 2017 Apr 15;305:162-166. doi: 10.1016/j.jneuroim.2017.02.011. Epub 2017 Feb 16.
Recent studies suggest a need for refinement of the traditional two phase model of relapse onset multiple sclerosis (RMS) to include dynamically changing subgroups within the broad category of secondary progressive MS (SPMS). These studies challenge the traditional notion that relapses play a minor role in comparison to a secondary progressive (perhaps degenerative) process. Patients fulfilling the broad definition for SPMS may take several courses, including variable rates and patterns of overall worsening. New paradigms or models for mapping the trajectory of disability in RMS and SPMS (clinical phenotyping), including periods of remission, may impact our understanding of the underlying pathology, and will be important in assessing treatments.
最近的研究表明，需要对复发型多发性硬化症（RMS）的传统两阶段模型进行细化，以便在继发进展型多发性硬化症（SPMS）这一广泛类别中纳入动态变化的亚组。这些研究对传统观念提出了挑战，即与继发进展（可能是退行性）过程相比，复发所起的作用较小。符合SPMS广义定义的患者可能会经历多个病程，包括总体病情恶化的不同速率和模式。用于描绘RMS和SPMS中残疾轨迹（临床表型分析）的新范式或模型，包括缓解期，可能会影响我们对潜在病理的理解，并且在评估治疗方面将具有重要意义。
